BACKGROUND:Treatments for cervical intraepithelial neoplasia remove precancerous cells from the cervix by excising or ablating the transformation zone. Most studies show no association between cervical intraepithelial neoplasia treatments and fertility outcomes. However, only 2 studies have examined time to pregnancy, both using retrospective study designs, with 1 study showing no association and the other showing a 2-fold increased risk of infertility (time to pregnancy >12 months) following excisional or ablative treatment. OBJECTIVE:We examined the association between cervical intraepithelial neoplasia treatments and fecundability. MATERIALS AND METHODS:We analyzed data from Pregnancy Study Online (PRESTO), a prospective cohort study of North American pregnancy planners enrolled during 2013-2019. At baseline, women reported whether they ever had an abnormal Papanicolaou test result, the number of abnormal Papanicolaou test results, and their age at first abnormal Papanicolaou test result. They also reported whether they underwent diagnostic (colposcopy) or treatment (excisional or ablative) procedures, and their age at each procedure. We restricted analyses to 8017 women with 6 or fewer cycles of attempt time at enrollment who reported receiving a Papanicolaou test in the previous 3 years. We estimated fecundability ratios and 95% confidence intervals using proportional probabilities models adjusted for sociodemographics, healthcare use, smoking, number of sexual partners, history of sexually transmitted infections, and human papillomavirus vaccination. RESULTS:A history of abnormal Papanicolaou test results showed little association with fecundability (fecundability ratio, 1.00; 95% confidence interval, 0.95-1.06). Likewise, receipt of colposcopy or treatment procedures, and time since treatment were not materially associated with fecundability. Results were similar when stratified by age and smoking status. CONCLUSION:We observed no appreciable association of self-reported history of abnormal Papanicolaou test results, colposcopy, treatments for cervical intraepithelial neoplasia, or recency of treatment with fecundability. These results agree with the majority of previous studies in indicating little effect of cervical intraepithelial neoplasia treatments on future fertility.

译文

背景:宫颈上皮内瘤变的治疗方法是切除或消融转化区,从子宫颈中去除癌前细胞。大多数研究表明宫颈上皮内瘤变治疗与生育结局之间没有关联。但是,只有两项研究使用回顾性研究设计检查了妊娠时间,其中一项研究显示无关联,而另一项研究显示,经切除或消融治疗后不孕风险增加(妊娠时间> 12个月)增加了2倍。
目的:我们研究了宫颈上皮内瘤变治疗与生育能力之间的关系。
材料与方法:我们分析了Pregnancy Study Online(PRESTO)的数据,PRESTO是一项针对2013-2019年间参与的北美妊娠计划者的前瞻性队列研究。基线时,妇女报告是否曾经有异常的帕帕尼古拉测试结果,异常的帕帕尼古拉测试结果数量以及首次出现帕潘尼古拉测试结果异常时的年龄。他们还报告了他们是否接受了诊断(阴道镜检查)或治疗(切除或消融)手术,以及他们每次手术的年龄。我们将分析仅限于8017名入选尝试时间少于或等于6个周期的女性,她们报告在过去3年中接受了Papanicolaou测试。我们使用比例概率模型(根据社会人口统计学,医疗保健用途,吸烟,性伴侣的数量,性传播感染的历史记录和人乳头瘤病毒疫苗接种情况)调整了比例概率模型,从而估算了可育度比率和95%的置信区间。
结果:Papanicolaou测试结果异常的历史表明与生育力关系不大(生育率1.00; 95%置信区间0.95-1.06)。同样,接受阴道镜检查或治疗程序以及治疗后的时间与生育力也没有实质联系。按年龄和吸烟状况分层,结果相似。
结论:我们没有观察到自我报告的异常Papanicolaou检查结果,阴道镜检查,宫颈上皮内瘤变的治疗或近期可生育性的病史相关性。这些结果与大多数以前的研究相吻合,表明宫颈上皮内瘤变治疗对未来生育力影响很小。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录