Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries.
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.
Jakobsson
Maija
M
Department of Obstetrics and Gynaecology, University Hospital, PO Box 140, FIN-00029 Helsinki, Finland. maija.jakobsson@fimnet.fi
Gissler
Mika
M
Tiitinen
Aila
A
Paavonen
Jorma
J
Tapper
Anna-Maija
AM
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*