Procedures for treating precancerous cervical cancer do not reduce fertility, study showsBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h821 (Published 18 February 2015) Cite this as: BMJ 2015;350:h821
Procedures that are commonly used to diagnose and treat precancerous cervical cancer do not reduce women’s subsequent chances of getting pregnant, shows a large US study that unexpectedly found higher rates of pregnancy in women who had these procedures than in control groups.1
Women with an unclear or abnormal cervical screening test generally have a diagnostic colposcopy and biopsy to see whether any lesions are precancerous. Those women found to have precancerous lesions then undergo cryotherapy, a loop electrosurgical excision procedure, or another surgical treatment to remove abnormal cells and prevent progression to cervical cancer.
In the study reported in PLoS One, researchers examined medical records of 4137 women aged 14 to 53 who had undergone a cervical treatment procedure and followed them up for 12 years after their procedure to find out whether they became pregnant. They were compared with two control groups: 81 435 women who did not have a cervical procedure and 13 676 who had a colposcopy or biopsy diagnostic procedure but no treatment. All were members of the Kaiser Permanente health plan in Oregon and Washington, USA, from 1998 to 2009.
Results showed that 14% of women who had cervical treatment procedures became pregnant during the follow-up period, compared with 9% of women who did not undergo a procedure and 11% of those who had a biopsy or colposcopy.
“This is great news for the millions of women who have one of these procedures, but still want to have a family,” said the lead author, Allison Naleway, of the Kaiser Permanente Center for Health Research in Portland, Oregon. “There was a fear that these procedures could weaken the cervix and reduce fertility, but our study suggests that this is not the case.”
After adjusting for age, contraceptive use, and history of infertility, women who had undergone a cervical treatment procedure were almost 1.5 times more likely to conceive than untreated women. Naleway said that this might be associated with the first group being more sexually active, although the study had not collected data on sexual history. Further results from the study on birth outcomes will be reported later this year.
Cite this as: BMJ 2015;350:h821