Abstract
Large loop excision of the transformation zone (LLETZ) was introduced in the late 1980s and has now become the most popular method of treatment for cervical intraepithelial neoplasia (CIN). It is well known that women with CIN have demographic, behavioural, and sexual characteristics that put them at increased risk of pregnancy-related morbidity. Outcomes related to fertility are reported in two studies after LLETZ, one after laser conisation and after laser ablation, and one after cold knife conisation (CKC). The differences in the seriousness of adverse effects noted between CKC and LLETZ might be related to variations in the amount of tissue removed. Clinicians should counsel women appropriately before excisional treatment regarding the increased risk of preterm birth in a future pregnancy. Women requiring treatment with either CKC, laser conisation or a relatively large loop excision should be warned that they may warrant closer antenatal care in a subsequent pregnancy.
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