title: Frequency and patterns of abnormal Pap smears in Sudanese women with infertility: What are the perspectives?
abstract: BACKGROUND
  Pelvic inflammatory disease is one of the major causes of infertility in females. Also, women with infertility are at high-risk of developing cervical intraepithelial lesions or even carcinoma.
  
  
  OBJECTIVE
  To assess the prevalence and patterns of epithelial cell abnormalities in cervical smears in Sudanese infertile and fertile women.
  
  
  METHODS
  The present study included 200 cases (women with infertility) of age group 20-60 years who had routine pap smear. A total of 700 fertile women constituted the control group.
  
  
  RESULTS
  Among the 200 infertile women, 93.5% reported as negative for intraepithelial lesion or malignancy (NILM), and 6.5% were epithelial cell abnormalities (atypical squamous cells of undetermined significance and above). In the control group 96.6% of the smears reported as NILM and 3.4% as epithelial cell abnormalities. The percentage of abnormal pap smears in the infertile women was significantly higher when compared with the control group.
  
  
  CONCLUSIONS
  Epithelial cell abnormalities are significantly higher in women with infertility as compared with fertile women. Importantly, inflammatory smears were reported two times more than in the controls. We recommend pap smear as a routine practice for all women assessed for infertility problems. Further studies are necessary to evaluate the incidence of human papilloma virus infections in infertile women with abnormal cervical cytology.
authors.affiliation: Department of Pathology, Faculty of Medicine, Faculty of Medical Laboratory Sciences, University of Medical Sciences and Technology, Khartoum, Sudan.
authors.forename: Ahmed O
authors.initials: AO
authors.lastname: Almobarak
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Elhoweris
authors.forename: Hilmi M
authors.initials: HM
authors.lastname: Nour
authors.forename: Mohammed Abd Allah M
authors.initials: MA
authors.lastname: Ahmed
authors.forename: Al-Fadhil Alobeed
authors.initials: AF
authors.lastname: Omer
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Ahmed
keywords: Abnormal pap smear; genital tract infection; infertility