Frequency and patterns of abnormal Pap smears in Sudanese women with infertility: What are the perspectives?

BACKGROUND: Pelvic inflammatory disease is one of the major causes of infertility in females. Also, women with infertility are at high-risk of developing cervical intraepithelial lesions or even carcinoma. AIM: To assess the prevalence and patterns of epithelial cell abnormalities in cervical smears in Sudanese infertile and fertile women. MATERIALS AND METHODS: The present study included 200 cases (women with infertility) of age group 20-60 years who had routine pap smear. A total of 700 fertile women constituted the control group. RESULTS: Among the 200 infertile women, 93.5% reported as negative for intraepithelial lesion or malignancy (NILM), and 6.5% were epithelial cell abnormalities (atypical squamous cells of undetermined significance and above). In the control group 96.6% of the smears reported as NILM and 3.4% as epithelial cell abnormalities. The percentage of abnormal pap smears in the infertile women was significantly higher when compared with the control group. CONCLUSIONS: Epithelial cell abnormalities are significantly higher in women with infertility as compared with fertile women. Importantly, inflammatory smears were reported two times more than in the controls. We recommend pap smear as a routine practice for all women assessed for infertility problems. Further studies are necessary to evaluate the incidence of human papilloma virus infections in infertile women with abnormal cervical cytology.