Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case–control study
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Objective: To determine whether women with a history of surgery for cervical intraepithelial neoplasia (CIN) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12 months. Design: Case–control study. Setting: Iowa Health in Pregnancy Study (IHIPS), a population‐based case–control study of preterm and small‐for‐gestational‐age (SGA) live birth outcomes (from May 2002 through June 2005) in the USA. Sample: Women with an intended pregnancy and a history of either one prior cervical surgery (n = 152), colposcopy only (n = 151), or no prior cervical surgery or colposcopy (n = 1021). Methods: Cervical treatment history, pregnancy intention, time to pregnancy, and other variables were self‐reported by computer‐assisted telephone interviews. Odds ratios were calculated using logistic regression to estimate the risk of prolonged time to pregnancy among women with a history of cervical surgery or colposcopy alone, compared with untreated women (control group). Main outcome measure: Prolonged time to pregnancy (i.e. >1 year). Results: Prolonged time to pregnancy was most prevalent among treated women (16.4%), compared with untreated women (8.4%) and women with colposcopy only (8.6%) (P = 0.039). After adjusting for covariates, women with prior cervical surgery had a more than two‐fold higher risk of prolonged time to pregnancy compared with untreated women (aOR 2.09, 95% CI 1.26–3.46). In contrast, women with a history of colposcopy only had a risk equivalent to that found among untreated women (aOR 1.02, 95% CI 0.56–1.89). Conclusions: Women with a history of cervical treatment for CIN are at increased risk of subfertility, measured as a time to pregnancy of more than 12 months.
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The effect on fertility of ablative therapies such as cryotherapy or laser vaporisation was assessed only in three studies in high-income countries.
“The effect on fertility of ablative therapies such as cryotherapy or laser vaporisation was assessed only in three studies in high‐income countries [13, 14, 15].”
From Fertility and Miscarriage Incidence After Cervical Intraepithelial Neoplasia Treatment by Thermal Ablation: A Cohort Study (2025) · cites this paper as [13]
A meta-analysis published in 2014 assessing fertility and early pregnancy outcomes after treatment of patients with suspected cervical precancerous disease identified only three studies assessing ablative methods, none of which included patients treated by thermal ablation.
“A meta‐analysis published in 2014 [12] assessing fertility and early pregnancy outcomes after treatment of patients with suspected cervical precancerous disease identified only three studies assessing ablative methods [13, 14, 23], none of which included patients treated by TA.”
From Fertility and Miscarriage Incidence After Cervical Intraepithelial Neoplasia Treatment by Thermal Ablation: A Cohort Study (2025) · cites this paper as [13]
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Research works printed but not linked: 22
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Kyrgiou, M., Athanasiou, A., Paraskevaidi, M., Mitra, A., Kalliala, I., Martin-Hirsch, P., Arbyn, M., Bennett, P., & Paraskevaidis, E. (2016) · BMJ · doi:10.1136/bmj.i3633 · Cited by 495 · see citing works
A prospective study of treatments for cervical intraepithelial neoplasia and fecundability
Wise, L. A., Willis, S. K., Perkins, R. B., Wesselink, A. K., Klann, A., Crowe, H. M., Hahn, K. A., Mikkelsen, E. M., & Hatch, E. E. (2020) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.12.017 · Cited by 14 · see citing works
Wisniak, A., Yakam, V., Bolo, S. E., Moukam, A., Sormani, J., Vassilakos, P., Kenfack, B., & Petignat, P. (2025) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17954 · Cited by 4 · see citing works
- Authors
- Spracklen, C., Harland, K., Stegmann, B., & Saftlas, A.
- Affiliations
- University of Iowa (US)
- Department of Occupational and Environmental Health Injury Research Prevention Center University of Iowa College of Public Health Iowa City IA USA
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2013-03-14
- Volume
- 120
- Issue
- 8
- Pages
- 960-965
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- PMC
- PMC3691952
- OpenAlex
- W2006810653
- Cited by
- 52
- References
- 0
- Citations by year
- 2024: 6 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 1 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 7 · 2014: 4 · 2013: 3
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (R21AI068111, R21 AI1068111)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039753)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- cervical intraepithelial neoplasia, cervical surgery, subfertility, time to pregnancy, infertility, colposcopy, live birth, pregnancy intention
- MeSH terms
- Adolescent, Adult, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Female, Fertilization, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Infant, Small for Gestational Age, Infertility, Female, Iowa, Middle Aged, Pregnancy, Pregnancy Complications, Neoplastic, Risk Factors, Prevalence, Case-Control Studies, Live Birth, Young Adult
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