The abnormalities do not appear to be associated with tubal infertility, writes senior author Leon Massuger, MD, and colleagues at Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

In The Netherlands, all women between the ages of 30 and 60 years undergo cervical-smear testing as part of a population-based screening program for cervical cancer. Smears are also collected from all women eligible for in vitro fertilization (IVF) at the Radboud University fertility clinic. The investigators hypothesized that patients at the fertility clinic would have a higher-than-average prevalence of severely abnormal smears, based on the clinical observation that many women are referred to the university's colposcopy unit for cytological abnormalities. The research team conducted a retrospective study of all smears collected from January 2000 to December 2003, comparing those smears from women eligible for IVF at the clinic to those smears obtained in the screening program.

A total of 77,055 smears from the cervical-screening program were compared to 668 smears from the IVF candidates, whose specimens showed significantly more dysplasia (P < .015). There were no significant differences in smears taken from women with tubal-factor infertility than from those in the comparison group.

In general, the incidence of sexually transmitted diseases is higher among women who visit fertility clinics than in the general population, the authors point out. As many as 24% of women at fertility clinics, for example, test positive for Chlamydia trachomatis in various surveys, compared to a general incidence of 2% to 5%. Although the causes of the abnormal cervical smears in this study have not been identified, high-risk human papillomavirus is a sexually transmitted disease, so it is not unreasonable to think its prevalence may be higher than average in this population.

The authors concluded by recommending routine cervical smears for all women undergoing treatment for fertility problems.


[Presentation title: Severe Cervical Abnormalities More Common in Subfertile Women. Poster 388]

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