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Pregnancy After a LEEP Procedure

Should You Get Pregnant After Having a LEEP?

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Updated May 28, 2014

When a woman has been told to undergo a LEEP to treat high-risk cervical dysplasia, her first concern may be how the procedure will affect future pregnancies. Tales of infertility, miscarriage, and pre-term labor are often the first things women hear when researching a LEEP. How does a LEEP really affect pregnancy? Are LEEP procedures responsible for miscarriages and pre-term births?

What Exactly Is a LEEP?

LEEP is an acronym used to describe "loop electrosurgical excision procedure," a procedure done to treat persistent low-grade dysplasia and high-grade cervical dyplasia. A LEEP uses an electrically charged wire loop to remove cervical tissue. It's done under local anesthesia and normally on an outpatient basis in hospitals or in the doctor's office.

During a LEEP procedure, a wire loop electrode with an electrical current is used to remove abnormal tissue from the cervix.

Risks Associated with Pregnancy After LEEP

The risks associated with LEEP and pregnancy are:
  • Cervical Incompetence: When a woman's cervix is diagnosed as "incompetent," it means the cervix is unable to stay closed during a pregnancy. Cervical incompetence can result in miscarriage and pre-term labor. However, a cervical cerclage can be done to ensure the cervix remains closed during the pregnancy. A cerclage basically means that the cervix is sewn closed for the duration of the pregnancy. Only a small percentage of woman who have had a LEEP will require a cerclage in pregnancy.

  • Cervical Stenosis:
  • Cervical stenosis is the tightening and narrowing of the cervix. This can cause the cervix difficulty in dilating during labor.

  • Infertility: Although extremely rare, a LEEP may cause a woman to become infertile. However, research on LEEP and fertility is very limited.

A LEEP is a safe and highly effective treatment for cervical dysplasia. How a future pregnancy will be affected by a LEEP depends on how much cervical tissue has been removed by the LEEP and whether LEEP or other cervical surgery has been previously performed. Keep in mind that there is about a 10% risk of pre-term delivery associated with LEEP. Most women do go on to have healthy, full term pregnancies.

Questions to Ask Your Doctor

There are several questions you should ask your doctor about LEEP if you plan on becoming pregnant:
  • How do you think a LEEP will affect my pregnancy?
  • Is a LEEP the only treatment option I have?
  • How long will it take for my cervix to recover?
  • When can I begin to have sex again?
  • How long after a LEEP can I try to get pregnant?

During Pregnancy

Be sure to inform your doctor if you have had a LEEP at your first obstetric appointment. Providing your doctor with information, such as notes taken by the doctor during the LEEP and pathology reports, will help him or her determine the best way to manage the pregnancy.

Sources:

"Surgery." Cervical Cancer:Detailed Guide. 04 Aug 2006. American Cancer Society. 5 Jan 2009

"Treatment Options by Stage." Cervical Cancer:Detailed Guide. 04 Aug 2006. American Cancer Society. 7 Jan 2009.

Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. "Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis." The Lancet 367(2006): 489-498.

Montz FJ. Impact of therapy for cervical intraepithelial neoplasia on fertility.. Am J Obstet Gynecol 1996; 175: 1129-1136.

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