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Hum. Reprod. Advance Access originally published online on July 16, 2008
Human Reproduction 2008 23(10):2252-2255; doi:10.1093/humrep/den271
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries

Maija Jakobsson1,4, Mika Gissler2,3, Aila Tiitinen1, Jorma Paavonen1 and Anna-Maija Tapper1

1 Department of Obstetrics and Gynaecology, University Hospital, PO Box 140, FIN-00029 Helsinki, Finland 2 STAKES National Research and Development Centre for Welfare and Health, PO Box 220, Helsinki, Finland 3 Nordic School of Public Health, Gothenburg, Sweden

4 Correspondence address. E-mail: maija.jakobsson{at}fimnet.fi

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.

Key words: treatment for CIN/conization/subfertility/IVF/preterm delivery

Submitted on December 12, 2007; resubmitted on May 30, 2008; accepted on June 9, 2008.


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