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Human Papillomavirus
Can HPV Affect Your Fertility, Pregnancy or Baby?
By Teri Brown
Dr. Fink says the two common treatments for pre-cancers are cryotherapy and cone biopsies. Cryotherapy is the freezing of superficial cells in an effort to rid the cervix of those pre-cancer cells. This can have an effect on the mucous-producing cells of the cervix that are related to fertility.
Cone biopsies are reserved for so-called "high-grade" pre-cancers and actually remove a small portion of the cervix containing the diseased tissue. Too large a cone biopsy or the need for multiple procedures over a woman's life due to recurrent high-grade pre-cancers can result in a weakness of the tissue when it comes to holding a pregnancy inside. This is known as an incompetent cervix.
"The benefit of treating high-grade pre-cancers exceeds the risk in most cases," Dr. Fink says. "The treatment of low-grade pre-cancers is controversial, as many will resolve on their own given enough time. Women should feel comfortable in asking their gynecologist about their proposed treatments, but should feel comfortable that, by the nature of our training, every OB/GYN heavily weighs concerns of fertility when recommending a course of therapy."
HPV is also the cause of warty growths and pre-cancers/cancers on the genital skin. Condyloma is aesthetically unpleasing, and pre-cancers are potentially dangerous. They are not known, however, to affect fertility unless they grow so large as to prevent vaginal intercourse.
"Performing a pap smear at the initial OB visit is the standard of care, and it is not uncommon to find abnormalities at that time," Dr. Fink says. "Pregnant women with abnormal pap smears still undergo colposcopy, though we usually do not perform biopsies of the cervix in pregnancy unless the abnormal area looks suspicious for a high-grade lesion."
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