DOES LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE OF THE CERVIX PREDISPOSE TO THE DEVELOPMENT OF ANTISPERM ANTIBODIES IN WOMEN

Objective: To determine whether large loop excision of the transformat ion zone of the uterine cervix for cervical intraepithelial neoplasia predisposes to the development of female isoimmunity to human spermato zoa. Design: A prospective, controlled study. Setting: Colposcopy and Andrology units at the John Radclife and Churchill Hospitals, Oxford, United Kingdom. Interventions: Serum samples were collected from 33 wo men before large loop excision of the transformation zone of the cervi x and repeated at a minimum time interval of 4 months after the proced ure. Women were questioned regarding the procedure and subsequent repr oductive function. A control population of 30 women not undergoing cer vical surgery also underwent serial serum screening for antisperm anti bodies. Main outcome measure(s): The detection of serum antisperm anti bodies by flow cytometry. Results: None of the serum samples before la rge loop excision of the cervical transformation zone had clinically s ignificant levels of antisperm antibodies. There was, however, a signi ficant rise in antisperm antibody levels in women following large loop excision of the transformation zone. Apparent risk factors for the de velopment of antisperm antibodies included a short duration of sexual abstinence and the use of nonbarrier contraception after surgery. Ther e was no rise in antisperm antibody levels in the control population. Conclusion: Large loop excision of the transformation zone of the cerv ix is a risk factor for the development of antisperm antibodies in wom en. Women should be advised to use barrier contraception or avoid sexu al intercourse until complete healing of the cervix has occurred.