Cervical Factor Infertility

Q. When I was younger, I had an abnormal pap smear and was told that my cervix needed to be treated. The doctor performed “cryotherapy” and since then my pap smears have been normal. Now that we are trying to get pregnant, I wonder if there is reason for concern related to having my cervix frozen.

A. Having cryosurgery “freezing” your cervix rarely causes a complication with getting pregnant. The cervix functions by making watery mucus around the time of ovulation that makes it easy for the sperm to swim to the egg. After surgery on their cervix, some women have a decrease in mucus production. When there is a decrease in mucus, sperm may have trouble getting to the egg for fertilization. This can easily be treated with intrauterine inseminations (IUI). IUI is a common fertility procedure that improves fertility in most couples. There is no more discomfort with an IUI than a woman encounters with a Pap smear. A small catheter is placed through the cervix and into the woman and the sperm are injected there. This places the sperm beyond and damaged cervical glands. There is one other thing to think about in women with a history of cryosurgery of her cervix; they are at a slightly increased risk of having tubal damage for a number of reasons. If pregnancy does not occur soon, even with IUI, a test of the fallopian tubes would also be helpful.

One other concern about more advanced treatments for cervical dysplasia, including removing some of the cervix (cold knife cone or LEEP procedures) is that scarring might occur that could limit the outflow of menstrual blood. Women with this problem often notice an increase in pelvic discomfort during their menses. In addition to causing infertility, cervical stenosis could also favor the development of endometriosis.