Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries

Abstract

BACKGROUND: The aim was to study whether the treatment of cervical intraepithelial neoplasia (CIN) is associated with a subsequent increase in the use of IVF to achieve deliveries and whether women with cervical treatment and IVF have increased rates of preterm delivery. METHODS: This was a register-based retrospective cohort (n = 822 183 deliveries) study from Finland whose main outcome measures were the rates of IVF and preterm deliveries in different CIN treatment groups. RESULTS: Of all deliveries in Finland, 1.5% (12 240) resulted from IVF treatment. This proportion was 1.6% for women who had undergone any cervical procedure [n = 150, risk ratio (RR): 1.21, confidence interval (CI): 1.04-1.42]. The risk for IVF was not increased after cervical conization, whether by loop or laser (1.6%), or ablation (1.8%). An increased number of IVF deliveries (2.7%) was observed following other excisional treatments, even when adjusted for year of delivery (RR: 1.83, CI: 1.16-2.89) or parity (RR: 1.95, CI: 1.25-3.04). Although women who had undergone any cervical procedure and IVF appeared to have an increased relative risk for preterm delivery (3.42-fold, CI: 2.18-5.37) when compared with women with neither, this was explained by maternal age and parity. CONCLUSIONS: The proportion of IVF deliveries was not increased after cervical conization or ablation. This is reassuring for young women who undergo such treatments. © The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.