Influence of ovarian stimulation on the detection of human papillomavirus DNA in cervical scrapes obtained from patients undergoing assisted reproductive techniques

Objective: To determine whether gonadotropin stimulation influences the det ection of human papillomavirus (HPV) DNA in cervical scrapes. Design: Prospective, controlled study. Setting: Tertiary care infertility clinic. Patient(s): Two hundred ninety-four patients enrolled in an IVF or IUI prog ram. Two thousand two hundred sixty-two women from an ongoing screening stu dy who were of similar age served as a control group. Intervention(s): Cervical scrapes were obtained with a cytobrush before and after ovarian stimulation with gonadotropins. Main Outcome Measure(s): Human papillomavirus status was assessed with a ge neral primer (GP) polymerase chain reaction (PCR) using the GP5+/GW6+ syste m. In GP-PCR-positive samples, high-risk HPV types were identified with a c ocktail of digoxigenin-labeled oligonucleotides. Viral load was evaluated b y semiquantitative analysis of the PCR products. Result(s): The prevalence of high-risk HPVs was 7.8% before stimulation and 6.8% after stimulation and, thus, was similar to the prevalence in control s (8.4%). Twenty-nine patients were positive for high-risk HPVs: 14 were po sitive before and after stimulation, 6 were negative before and positive af ter stimulation, and 9 were positive before and negative after stimulation. Positivity for high-risk HPVs and viral load did not correlate directly wi th serum estrogen levels. Conclusion(s): Ovarian stimulation has no significant effect on the prevale nce of HPV DNA in cervical scrapes obtained from patients undergoing assist ed reproductive techniques. (C) 1999 by American Society for Reproductive M edicine.