Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 191

Good practice would be to ensure all patients referred to fertility clinics are up to date with their local cervical screening program, and if they are not, they should be encouraged to take up this opportunity to have the screening. This also includes couples in same sex female relationships. This should ideally have been done in primary care prior to referring the patient, but if it has not been done, this should again be encouraged to be undertaken before undergoing fertility investigations and treatment. All patients should be strongly encouraged to stop smoking, as those who persist with smoking are less likely to find their precancerous cells resolve.

Women who are attending for consideration for assisted reproduction techniques (ART) are often stressed because of their fertility issues. Any additional issues will only compound this. Women with abnormal cervical cytology, who are referred for colposcopy, are also at increased stress, often comparable to levels seen prior to major surgery. There are currently no national recommendations for clinical situations where the cervical sample shows an abnormality and the woman is considering treatment for infertility.

Women should be seen and assessed but not necessarily treated. To avoid overtreatment, women should not be seen on a “see and treat” basis. In women being considered for ART, it would be prudent to undertake immediate colposcopy. The advantage of this approach is that if the colposcopic assessment is normal, then no further action needs to take place apart from repeating the cervical sample in 6 months.