Cervical dysplasia

What is cervical dysplasia?

Cervical dysplasia is a pathological change that occurs in the cells of the cervical epithelium and is characterized by a disturbance in their maturation process. Due to these structural changes, epithelial cells become atypical or abnormal. The abnormal growth of cells on the surface of the cervix could potentially lead to cervical cancer.

According to the World Health Organization, cervical dysplasia affects one in four women of childbearing age. The disease does not always cause obvious symptoms, so women may ignore the problem until they undergo medical examinations.

Like other intraepithelial neoplasms, cervical dysplasia is not cancer and is generally curable. Most cases of cervical dysplasia remain stable or are eliminated by the person's immune system without intervention. However, if untreated, a small percentage of cases may progress to cervical cancer, usually a cervical squamous cell carcinoma.

Is cervical dysplasia dangerous?

Cervical dysplasia is considered a precancerous condition, and its main danger lies in its latent progression. The transition from one stage to another usually takes 1 to 3 years, and in some cases, the disease may not progress for up to 10 years. Doctors consider the most concerning lesions to be those in the basal layer, which is responsible for the renewal of the epithelium.

The rate of development of dysplasia depends on concomitant factors, including the patient's age, hormone levels, the presence or absence of chronic diseases, and poor lifestyle habits. Regular preventive examinations by a gynecologist can help prevent the onset of cervical cancer.

Main stages of cervical dysplasia

Depending on the degree of involvement of the epithelial layer, three degrees of cervical dysplasia are distinguished:

• Mild dysplasia (CIN I): pathological changes affect only one-third of the epithelium. The risk of progression does not exceed 10 to 15%.
• Moderate dysplasia (CIN II): the lesion covers two-thirds of the thickness of the epithelium. The probability of developing the disease is 20 to 30%.
• Severe dysplasia (CIN III): the epithelium is affected throughout, the risk of progression is 30 to 50%.

Causes of cervical dysplasia

The main factor in the development of dysplasia is infection with human papillomavirus (HPV), particularly with highly oncogenic subtypes 16 and 18. Other risk factors include:

• Early sexual activity (before the age of 16-18);
• A large number of sexual partners;
• Chronic infectious diseases of the reproductive system;
• Early first pregnancy (before 20 years), frequent abortions;
• Family history of cervical cancer;
• Cervical trauma;
• Weakened immunity, stress, smoking, and other bad habits;
• Refusal to undergo preventive visits to a gynecologist.

Signs and symptoms of cervical dysplasia

In most cases, dysplasia is asymptomatic. However, the following manifestations are possible:

• Unusual vaginal discharge (watery or foul-smelling);
• Menstrual cycle disturbances;
• Discomfort, burning, pain during and after intercourse;
• Slight blood-tinged discharge after intercourse;
• Pulling pain in the lower abdomen.

Diagnosis of cervical dysplasia

Diagnosis requires a comprehensive approach. The main examination methods include:

• PAP test (cytological examination);
• Colposcopy (examination of the cervix using a colposcope);
• HPV test (determination of oncogenic strains of HPV);
• Biopsy (histological examination of a tissue sample).

Treatment of cervical dysplasia

Treatment tactics are determined individually. The main approaches are:

Conservative treatment

It is used in the early stages and includes:

• Antiviral medications;
• Immunomodulatory medications;
• Vitamin therapy (A, E, C);
• Hormonal correction;
• Restoration of vaginal microflora.

Surgical treatment

It is used in cases of severe dysplasia or lack of effect from medical treatment. Methods include:

• Cryodestruction;
• Laser vaporization;
• Radio wave therapy.

Prevention of cervical dysplasia

To prevent the development of dysplasia, doctors recommend:

• Regular examinations by a gynecologist;
• Vaccination against papillomavirus;
• Use of condoms;
• Strengthening the immune system;
• Treating infections of the genital tract;
• Quitting smoking and alcohol;
• Monitoring the health of partners.

Pregnancy with cervical dysplasia

Natural conception

Women with mild or moderate dysplasia can conceive naturally, but they should be under constant medical supervision. Regular monitoring of the cervix and cytological tests help control the progression of the disease. In most cases, pregnancy does not affect dysplasia, but a new examination is recommended after childbirth.

Pregnancy after IVF

Women diagnosed with cervical dysplasia who have difficulty conceiving can resort to in vitro fertilization (IVF). Before starting the protocol, it is important to undergo a thorough examination to assess the condition of the cervical epithelium. In cases of severe dysplasia, it is recommended to undergo treatment first and plan a pregnancy afterward.

IVF with donor eggs

For women with concomitant gynecological diseases or genetic risks, IVF with donor eggs may be recommended. This can significantly increase the chances of a successful pregnancy, especially if your own eggs do not meet the required quality criteria.

When to see a doctor?

If you have been diagnosed with cervical dysplasia and are considering becoming parents, it is important to undergo a detailed diagnosis and seek expert advice. We recommend consulting a gynecologist as soon as possible. Make an appointment at the "Natuvitro" clinic in Barcelona for a detailed diagnosis and prompt treatment.