BACKGROUND: Treatments for cervical intraepithelial neoplasia remove precancerous cells from the cervix by excising or ablating the transformation zone. Most studies show no association between cervical intraepithelial neoplasia treatments and fertility outcomes. However, only 2 studies have examined time to pregnancy, both using retrospective study designs, with 1 study showing no association and the other showing a 2-fold increased risk of infertility (time to pregnancy >12 months) following excisional or ablative treatment. OBJECTIVE: We examined the association between cervical intraepithelial neoplasia treatments and fecundability. MATERIALS AND METHODS: We analyzed data from Pregnancy Study Online (PRESTO), a prospective cohort study of North American pregnancy planners enrolled during 2013-2019. At baseline, women reported whether they ever had an abnormal Papanicolaou test result, the number of abnormal Papanicolaou test results, and their age at first abnormal Papanicolaou test result. They also reported whether they underwent diagnostic (colposcopy) or treatment (excisional or ablative) procedures, and their age at each procedure. We restricted analyses to 8017 women with 6 or fewer cycles of attempt time at enrollment who reported receiving a Papanicolaou test in the previous 3 years. We estimated fecundability ratios and 95% confidence intervals using proportional probabilities models adjusted for sociodemographics, healthcare use, smoking, number of sexual partners, history of sexually transmitted infections, and human papillomavirus vaccination. RESULTS: A history of abnormal Papanicolaou test results showed little association with fecundability (fecundability ratio, 1.00; 95% confidence interval, 0.95-1.06). Likewise, receipt of colposcopy or treatment procedures, and time since treatment were not materially associated with fecundability. Results were similar when stratified by age and smoking status. CONCLUSION: We observed no appreciable association of self-reported history of abnormal Papanicolaou test results, colposcopy, treatments for cervical intraepithelial neoplasia, or recency of treatment with fecundability. These results agree with the majority of previous studies in indicating little effect of cervical intraepithelial neoplasia treatments on future fertility.
BACKGROUND: Treatments for cervical intraepithelial neoplasia remove precancerous cells from the cervix by excising or ablating the transformation zone. Most studies show no association between cervical intraepithelial neoplasia treatments and fertility outcomes. However, only 2 studies have examined time to pregnancy, both using retrospective study designs, with 1 study showing no association and the other showing a 2-fold increased risk of infertility (time to pregnancy >12 months) following excisional or ablative treatment. OBJECTIVE: We examined the association between cervical intraepithelial neoplasia treatments and fecundability. MATERIALS AND METHODS: We analyzed data from Pregnancy Study Online (PRESTO), a prospective cohort study of North American pregnancy planners enrolled during 2013-2019. At baseline, women reported whether they ever had an abnormal Papanicolaou test result, the number of abnormal Papanicolaou test results, and their age at first abnormal Papanicolaou test result. They also reported whether they underwent diagnostic (colposcopy) or treatment (excisional or ablative) procedures, and their age at each procedure. We restricted analyses to 8017 women with 6 or fewer cycles of attempt time at enrollment who reported receiving a Papanicolaou test in the previous 3 years. We estimated fecundability ratios and 95% confidence intervals using proportional probabilities models adjusted for sociodemographics, healthcare use, smoking, number of sexual partners, history of sexually transmitted infections, and humanpapillomavirus vaccination. RESULTS: A history of abnormal Papanicolaou test results showed little association with fecundability (fecundability ratio, 1.00; 95% confidence interval, 0.95-1.06). Likewise, receipt of colposcopy or treatment procedures, and time since treatment were not materially associated with fecundability. Results were similar when stratified by age and smoking status. CONCLUSION: We observed no appreciable association of self-reported history of abnormal Papanicolaou test results, colposcopy, treatments for cervical intraepithelial neoplasia, or recency of treatment with fecundability. These results agree with the majority of previous studies in indicating little effect of cervical intraepithelial neoplasia treatments on future fertility.
Authors: Marie E Thoma; Alexander C McLain; Jean Fredo Louis; Rosalind B King; Ann C Trumble; Rajeshwari Sundaram; Germaine M Buck Louis Journal: Fertil Steril Date: 2013-01-03 Impact factor: 7.329
Authors: Lauren A Wise; Kenneth J Rothman; Ellen M Mikkelsen; Joseph B Stanford; Amelia K Wesselink; Craig McKinnon; Siobhan M Gruschow; Casie E Horgan; Aleta S Wiley; Kristen A Hahn; Henrik Toft Sørensen; Elizabeth E Hatch Journal: Paediatr Perinat Epidemiol Date: 2015-07 Impact factor: 3.980
Authors: Maurizio Macaluso; Tracie J Wright-Schnapp; Anjani Chandra; Robert Johnson; Catherine L Satterwhite; Amy Pulver; Stuart M Berman; Richard Y Wang; Sherry L Farr; Lori A Pollack Journal: Fertil Steril Date: 2008-11-06 Impact factor: 7.329
Authors: Penelope P Howards; Enrique F Schisterman; Charles Poole; Jay S Kaufman; Clarice R Weinberg Journal: Am J Epidemiol Date: 2012-08-17 Impact factor: 4.897
Authors: Roy M Nilsen; Stein Emil Vollset; Håkon K Gjessing; Rolv Skjaerven; Kari K Melve; Patricia Schreuder; Elin R Alsaker; Kjell Haug; Anne Kjersti Daltveit; Per Magnus Journal: Paediatr Perinat Epidemiol Date: 2009-11 Impact factor: 3.980