{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:36:50Z","timestamp":1777441010419,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T00:00:00Z","timestamp":1363219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether women with a history of surgery for cervical intraepithelial neoplasia (<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Iowa Health in Pregnancy Study (<jats:styled-content style=\"fixed-case\">IHIPS<\/jats:styled-content>), a population\u2010based case\u2013control study of preterm and small\u2010for\u2010gestational\u2010age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>) live birth outcomes (from May 2002 through June 2005) in the <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Women with an intended pregnancy and a history of either one prior cervical surgery (<jats:italic>n<\/jats:italic>\u00a0=\u00a0152), colposcopy only (<jats:italic>n<\/jats:italic>\u00a0=\u00a0151), or no prior cervical surgery or colposcopy (<jats:italic>n<\/jats:italic>\u00a0=\u00a01021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cervical treatment history, pregnancy intention, time to pregnancy, and other variables were self\u2010reported by computer\u2010assisted 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Prolonged time to pregnancy (i.e. &gt;1\u00a0year).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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%) (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.039). After adjusting for covariates, women with prior cervical surgery had a more than two\u2010fold higher risk of prolonged time to pregnancy compared with untreated women (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\u00a02.09, 95%\u00a0CI 1.26\u20133.46). In contrast, women with a history of colposcopy only had a risk equivalent to that found among untreated women (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\u00a01.02, 95%\u00a0CI 0.56\u20131.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with a history of cervical treatment for <jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content> are at increased risk of subfertility, measured as a time to pregnancy of more than 12\u00a0months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12209","type":"journal-article","created":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T22:38:52Z","timestamp":1363300732000},"page":"960-965","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case\u2013control study"],"prefix":"10.1111","volume":"120","author":[{"given":"CN","family":"Spracklen","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KK","family":"Harland","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health Injury Research Prevention Center University of Iowa College of Public Health Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BJ","family":"Stegmann","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AF","family":"Saftlas","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmi047"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348209156591"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1985.tb01068.x"},{"key":"e_1_2_7_5_1","first-page":"815","article-title":"Impact of the loop electrosurgical excision procedure on future fertility","volume":"41","author":"Turlington WT","year":"1996","journal-title":"J Reprod Med"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90881-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)90622-X"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1968.tb02090.x"},{"key":"e_1_2_7_9_1","first-page":"157","article-title":"Fertilidad de la mujer conizada","volume":"44","author":"Fertilio O","year":"1979","journal-title":"Rev Chil Obstet Ginecol"},{"key":"e_1_2_7_10_1","first-page":"146","article-title":"Fertilidad postconizacion cervicouterina","volume":"46","author":"Capurro I","year":"1981","journal-title":"Rev Chil Obstet Ginecol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(82)90752-9"},{"key":"e_1_2_7_12_1","first-page":"86","article-title":"Conservative treatment of cervical intraepithelial neoplasia using a cold knife section technique","volume":"121","author":"Mazouni C","year":"2005","journal-title":"Reprod Biol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70016-9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91487-0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443619409030016"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)90782-K"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016347909154594"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.050"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws120"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmp048"},{"key":"e_1_2_7_21_1","unstructured":"US Center for Disease Control and Prevention (CDC).Pregnancy Risk Assessment Monitoring System (PRAMS) 2009. 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