Introduction: Abnormal cervical lesions are characterized by atypical cellular changes in the cervix that have the potential to progress to cervical cancer. This study aimed to assess the prevalence of abnormal cervical lesions among women with infertility compared with fertile women.
Methods: This cross-sectional study was conducted on 250 women with infertility and 250 fertile women who were referred to the Infertility Center and Women’s Clinic of Afzalipour Hospital in Kerman. Participants were selected using a convenience sampling method. Pap smear tests were performed for all participants. In cases of abnormal cervical findings, colposcopy and biopsy were subsequently performed. All samples were sent to the pathology laboratory to determine the frequency of precancerous cervical lesions.
Results: The mean age was 35.17±9.07 years in the infertile group and 34.32±5.95 years in the fertile group, with no statistically significant difference between the two groups (P = 0.217). Abnormal cervical findings were detected in 9.2% of fertile women and 8.4% of infertile women (P = 0.752). Among fertile women with abnormal results, 78.2% had low-grade squamous intraepithelial lesions (LSIL) and 21.8% had atypical squamous cells of undetermined significance (ASC-US). In the infertile group, 71.4% had LSIL and 28.6% had ASC-US. No high-grade Pap smear abnormalities were observed in either group. Based on Pap smear findings, HPV positivity was detected in 4.8% of fertile women and 4.4% of infertile women, with no statistically significant difference between the groups (P = 0.831). Colposcopic evaluation of women with abnormal Pap smear results revealed that 43.5% of fertile women had cervical intraepithelial neoplasia grade I (CIN I) and 21.7% had CIN II. In the infertile group, 28.6% had CIN I and 28.6% had CIN II. No significant difference was observed between the two groups in terms of colposcopy findings (P = 0.588). Abnormal Pap smear findings were observed in 8.2% of women with primary infertility and 9.2% of women with secondary infertility (P= 0.378).
Conclusions: Routine Pap smear screening is recommended for all women with infertility who present to obstetrics and gynecology clinics or sexually transmitted disease (STD) clinics.