title: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, PO Box 140, FIN-00029 Helsinki, Finland. maija.jakobsson@fimnet.fi
authors.forename: Maija
authors.initials: M
authors.lastname: Jakobsson
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tapper
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007246:Infertility / Q000453:epidemiology*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000601:surgery*