Assessment of Cervical Genotoxicity in Infertile Women Receiving IVF Therapy Using Micronucleus Test

Background: In vitro fertilization (IVF) has become a widely used method of assisted reproduction. However, concerns remain regarding the potential genotoxic effects of ovarian stimulation protocols used during IVF, especially in relation to cervical epithelial cells. The micronucleus (MN) assay is a validated cytogenetic biomarker of chromosomal damage and genome instability, increasingly utilized in cancer risk assessment. This study aimed to evaluate the genotoxic effect of IVF treatment on cervical epithelial cells in infertile women by comparing MN frequency before and after IVF cycles and with matched healthy controls. Methods: This prospective observational study included 15 women undergoing IVF and 15 age-matched healthy controls. All IVF participants had primary infertility and were undergoing their first IVF/ICSI cycle. Cervical smear samples were collected from the IVF group before and three months after treatment failure. MN assay was applied, and cytogenetic parameters (MN, binucleated cells, broken egg cells, and budding cells) were evaluated under light microscopy. Non-parametric statistical tests were used for analysis. Results: A statistically significant increase in MN frequency was found in the IVF group following treatment compared to pre-treatment samples and the control group (p = 0.001). HPV status was not assessed during the study period and is acknowledged as a key limitation. However, no significant differences were observed in other nuclear anomalies. Pre-treatment MN frequencies were not significantly different from those in controls. Conclusions: The findings suggest a potential cytogenetic impact of IVF-related hormonal stimulation on cervical epithelial cells, as evidenced by increased MN frequency. While no direct clinical implications were identified, these changes warrant further investigation into the long-term genomic safety of assisted reproductive technologies.