Pathology of cervical epithelium in women with various forms of infertility

Abstract

Failure to conceive in a couple, that does not prevent fertilization for 12 months or more, is defined as infertility. This diagnosis is special one both because of the social component and of the involvement of two persons in it, as well as because of polyetiological factors. Pathology of the cervical epithelium is a common problem among women of reproductive age. In patients with infertility, it has its own significance as a factor for fertility disorders. In addition, there is a possible influence of different methods of treatment of pathology of the cervical canal on the course of pregnancy that occurred after treatment.The objective: to study the prevalence of cervical pathology in patients with various types of infertility.Materials and methods. The results of liquid cytology and human papillomavirus (HPV) testing were analyzed in 416 women, who were divided into four groups: I group included 108 patients with infertility associated with anovulation, II group – 101 patients with infertility of tubal origin, III group – 102 women with a male infertility factor in marriage, IV group – 105 women who applied for a preventive examination.Results. The general frequency of early cervical lesions of severity various degrees was differed significantly in the groups of the examined persons – from the lowest 25.9% in the group of patients with infertility associated with anovulation, and 35.2% in the group of women who applied for a preventive examination, to 50.9 % among women with infertility of tubal origin and 52.4% – in the group with a male infertility factor.In the last two mentioned groups, the frequency of severe intraepithelial lesions (7.8% and 7.9%, respectively) was higher than in the other groups, where it was established at a level of no more than 1.5%. A higher rate of HPV infection was also established in the groups infertility of tubal origin – 68.6%, male infertility – 63.4%, while in the group of patients with anovulation infertility its prevalence was at the level of 35.1%, which does not exceed the rate of healthy women in control group – 25.7%.Conclusions. 1. Patients with infertility of tubal origin and male factor infertility have a higher frequency of early cervical changes (50.9% and 52.9%, respectively) than healthy women of reproductive age (35.2%). 2. In cases of tubal and male factor infertility, the frequency of HPV infection is higher than the rate of the cervical epithelium lesions detected by the cytological method (68.6% and 63.4%, respectively), which allows us to recommend the HPV test to include in the list of mandatory examinations during preparation for the program of assisted reproductive technologies.