Cervical screening when trying to conceive

What is cervical screening?

A cervical screening (a smear test) is a way of checking if there are any abnormal (unusual) cells in the cervix. Abnormal cells can be a sign of cancer.

It is your choice whether to have cervical screening or not.  

Why is cervical screening recommended?

Cervical screening is one of the best ways to protect yourself against cervical cancer.

During the screening appointment, a small sample of cells will be taken from your cervix. The sample is checked for certain types of human papillomavirus (HPV). HPV is the name for a very common group of viruses.

Most people will get HPV at some point. You can get it through any kind of sexual contact. Some types of HPV (called ‘high risk’ types) can cause cervical cancer if you do not have treatment.

You are recommended to have cervical screening even if you have had the HPV vaccination. This is because the vaccine doesn’t protect you from all types of HPV. 

Why do I need to do the test before getting pregnant?

Pregnancy can make it harder to know if your test result is normal or not. If you’re planning to get pregnant ask your GP if you are up to date with your cervical screening.  

Where can I get tested?

All women aged 25 to 64 who are registered with a GP get a letter inviting them for cervical screening every 3 years.  

If you’re planning a pregnancy there’s no need to wait for a letter. Contact your GP surgery to find out when your screening is due and tell your GP you are trying for a baby.  

You do not need a cervical screening if you are under 25.

I think I’m already pregnant. Should I still get tested?

Tell the GP or clinic if you are due for a routine cervical screening test and are pregnant or think you may be pregnant.  

You will usually be advised to delay your screening until at least 12 weeks after you’ve given birth. This is because pregnancy can make it harder to get clear results.

If you’ve had a previous abnormal screening result

If you need a repeat smear after a previous abnormality and you are now pregnant, you should still have your smear during pregnancy. The best time to do this is between 3 and 6 months of pregnancy.

What happens after cervical screening?

Most women will have a normal result. This means you have a very low risk of developing cancer before your next screening test in 3 or 5 years.

If you have HPV but no abnormal cells you will be invited for screening in 1 year.

If you have HPV and abnormal cells are found you’ll be asked to have a colposcopy. This is a test to take a closer look at your cervix. Talk to your GP or hospital if you are thinking about getting pregnant, or you think you may be pregnant, before you go to your colposcopy appointment.

Is cervical screening safe?

Having a cervical smear or having a colposcopy is safe. But if abnormal cells are found during your colposcopy and you need further treatment this can sometimes affect future pregnancies.

This depends on the type of treatment you have.

Sometimes a tiny sample called a punch biopsy is taken for testing from the cervix during colposcopy. Depending on the results, you may need treatment to destroy any abnormal cells. This can be done by heat treatment, laser or freezing. None of these treatments appear to cause any problems in pregnancy.  

Excisional biopsy is where a piece of tissue is removed from the centre of your cervix with the aim of removing all the abnormal cells.  This treatment may increase your risk of having a premature baby.

A cone biopsy removes a cone shaped wedge of tissue from your cervix. It can cause particular problems with future pregnancies, such as premature labour and having a baby with a low birth weight. But these are not common.

Sometimes abnormal cells are removed using a procedure called large loop excision of the transformation zone (LLETZ). This may slightly increase the risk of premature labour, having a low weight baby or your waters breaking early.

Try not to worry too much about these small risks. Most people who have had treatment to the cervix will have a successful pregnancy and deliver a healthy baby at full term (38 weeks or after).

Should I have treatment for an abnormal smear if I am thinking about having a baby?  

Tell the healthcare professional performing the colposcopy that you plan to get pregnant. Your doctor will make sure you get the care you need while keeping any risk to any future pregnancies to a minimum. This may mean doing less treatment initially, until your pregnancy is over, and then completing your treatment after your baby is born.

If I have had treatment, will I need additional care in pregnancy?

Because of the small increase in the risk of your baby being born prematurely that is linked with an excisional biopsy, you may be offered vaginal scans in pregnancy to measure the length of your cervix. This is particularly the case if you have had more than 1 treatment or if a large amount of your cervix was removed.

If you have had a baby born prematurely or a late miscarriage in the past and you have a weak cervix, you may be offered to have a stitch put around it to prevent it opening early.

Contact your colposcopy unit if you are unsure what type of treatment you have had. They should be able to tell you what type of biopsy/treatment you have had and how much tissue was removed.

Cervical cancer

If you are diagnosed with cervical cancer, this may affect your fertility. Jo’s cervical cancer trust has more information about cervical cancer and fertility.