Purpose of cervical screening before fertility treatment
Cervical screening checks for HPV infection and abnormal cells in the cervix that could develop into cervical cancer.
Before fertility treatment, it is important to make sure there are no untreated cervical abnormalities, because:
- Pregnancy-related hormonal changes can accelerate cervical changes.
- Treatment for abnormal cells (like LLETZ) can temporarily delay or affect fertility treatment.
- Some fertility clinics and IVF units require up-to-date cervical screening as part of pre-treatment checks.
Irish guidelines & recommendations
In Ireland there is no rule stating that everyone must have a cervical screening test before fertility treatment, but many Irish fertility clinics (especially private units) do ask for an up-to-date smear result as part of their pre-treatment paperwork.
What national Irish guidance says
The national cervical screening programme (CervicalCheck/HSE) recommends people attend when they are due; it explicitly says you can have a test if you are trying for a baby or undergoing fertility treatment, but it does not state that extra/early screening is required for everyone starting fertility treatment.
Recent Irish clinical guidance for IVF/fertility care (HSE / National Clinical Practice Guideline) describes the range of pre-treatment investigations but does not impose a nationwide mandatory rule that a screening test must be done before treatment starts. Public units will follow CervicalCheck pathways for abnormal results.
What individual (Irish) clinics do
Private clinic practice varies. Some private Irish clinics explicitly request a copy of a recent smear as part of the “pre-treatment” paperwork. For example a recent up to date cervical screening test is required in pre-treatment. Some clinics may require a screening test only if you are due or have an abnormal history.
Public tertiary hospitals (Cork University Hospital, Coombe, National Maternity Hospital etc.) provide colposcopy and CervicalCheck services and will follow the national screening algorithm — they typically do not require an extra smear if you are already up to date, but will require follow-up for abnormal results via colposcopy services.
What to do?
- Check your CervicalCheck status: if you are due for screening, book it (you can still have it while planning treatment).
- If your last smear was within the recommended interval and normal, you usually do not need an extra test just because you are starting fertility care. Bring a copy of the result or the CervicalCheck letter when you meet the clinic.
- If you had an abnormal smear (HPV positive, cell changes), follow through with colposcopy/treatment and tell your fertility team. They may postpone some interventions until management is complete.
- If you are planning to go private, expect some clinics to ask for an “up-to-date smear” and be ready to produce it (GP and or CervicalCheck letter).