Cervical Treatments Don't Hinder Fertility

The use of diagnostic colposcopy and biopsy and other procedures to diagnose and treat precancerous cervical lesions does not appear to decrease a woman’s chances of becoming pregnant.

In a Kaiser Permanente Northwest study published in PLOS ONE, researchers looked at medical records of nearly 100,000 women over a 12-year span. They found that women who underwent the common surgical procedures used for diagnosing and treating precancerous cervical lesions were actually more likely to become pregnant.

Key Points:

- Procedures and treatments used to address precancerous cervical lesions do not appear to decrease a woman’s chances of becoming pregnant.

- This is reassuring news for the millions of women who have had one of these procedures and want to grow their family.

“While the data we collected did not include sexual history, it is possible that the women who had these procedures may have been more sexually active than the untreated group, and that would explain the higher pregnancy rates,” said Allison Naleway, PhD, lead author and senior investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon, in a news release.

Still, Naleway said the study helps to alleviate a fear that the surgical procedures weaken the cervix and reduce fertility. The study included both excisional procedures (LEEP, LLETZ, or conization) and ablative procedures (electro or thermal) that remove the abnormal cells to prevent their progression to cervical cancer. These procedures have been linked to an increase in risk of preterm delivery, but research to better understand this link is limited, the study authors explain.

Of the women who had cervical treatment, 14% got pregnant, compared with 9% of women who did not have a procedure and 11% of women who had a biopsy or colposcopy. After adjusting for age, contraceptive use, and infertility, women who had a treatment procedure were almost 1.5 times more likely to conceive compared with women who were untreated.

In reaching that conclusion, the researchers found 570 pregnancies following cervical treatment in 4137 women, 1533 pregnancies following a diagnostic procedure in 13,767 women, and 7436 pregnancies in a frequency-matched sample of 81,435 women unexposed to treatment or diagnostic procedures.

Next, the researchers are looking at whether these procedures affected birth outcomes, such as preterm delivery. Results of that study are expected later this year.