Pregnancy After a LEEP Procedure: What to Know

Risks to Be Aware of and What to Ask Your Healthcare Provider

Table of Contents
View All
Table of Contents

The chances of a loop electrosurgical excision procedure, commonly known as LEEP, affecting a future pregnancy and birth are generally low, but it can happen. Trouble getting pregnant, preterm birth, low birth weight, and miscarriage have all been associated with pregnancy after a LEEP.

LEEPs are performed to treat persistent, low-grade and high-grade cervical dysplasia, which is an abnormal condition of the cervix. While you may need to this procedure to prevent precancer or cancer, which could develop if dysplasia goes untreated, you may be wondering about how safe pregnancy after a LEEP is.

This article will explore pregnancy and birth for those with a history of LEEP.

What to Expect During a Loop Electrosurgical Excision Procedure
Verywell / JR Bee

How Does LEEP Affect Pregnancy?

When faced with the prospect of undergoing a LEEP procedure, many people are concerned about how it will affect future pregnancies. Tales of infertility, miscarriage, and preterm labor are often the first things people hear when researching a LEEP.

Cervical Incompetence

People who've had a LEEP are more likely to have a shortened cervix, which may affect the ability of the cervix to stay closed during pregnancy. This is called an incompetent cervix. Cervical incompetence can result in miscarriage and preterm labor.

However, a cervical cerclage can be done to ensure that the cervix remains closed during the pregnancy. This means that the cervix is sewn closed for the duration of the pregnancy. Only a small percentage of people who have had a LEEP will require a cerclage during pregnancy.

Miscarriage

One study showed that women who became pregnant less than a year after their LEEP procedures had a higher risk of miscarriage. Study participants who had undergone a LEEP had a 28% chance of having a miscarriage, while a control group had only a 13% chance of miscarriage.

The good news is that the same study showed that women who were a year or more beyond their LEEP procedures had no more risk of miscarriage than any other women.

Cervical Stenosis

This refers to the tightening and narrowing of the cervix, which can happen in the small chance scar tissue forms over the cervical opening as a result of a LEEP. This can make it difficult for the cervix to dilate during labor.

Premature Birth

There's a 10% risk of preterm delivery (before 37 weeks) that's associated with LEEP. However, this was also found to be true with those who have had cervical dysplasia. This suggests that LEEP may not be the only factor in preterm birth.

Low Birth Weight

Although results from multiple studies have been mixed, one study did associate LEEP with low birth weight. This may be because of the increased risk of preterm birth with LEEP and, hence, a lower birth weight baby.

Research shows there is a small increased risk for preterm birth, adverse pregnancy outcomes, and low birth weight after a LEEP procedure, but most people have no problems.

Is It Difficult to Get Pregnant After a LEEP?

There are some concerns about fertility after a LEEP procedure. In the very rare case scar tissue does form over the cervical opening, this can theoretically cause irregular periods or prevent sperm from traveling to the uterus to fertilize an egg.

However, a meta-analysis reported that previous studies showed LEEP does not impact the ability to get pregnant.

Although there's a risk of preterm delivery associated with LEEP, many people do go on to have healthy, full-term pregnancies.

The ways in which a future pregnancy will be affected by a LEEP depend on how much cervical tissue has been removed and whether this particular procedure or any other cervical surgery has been previously performed. Talk to your healthcare provider if you have any concerns.

When Can You Start Trying to Conceive After a LEEP?

While immediate recovery can take two weeks, it can take up to six months for your cervix to fully heal after a LEEP. It's generally best to wait six months post-procedure to start trying to conceive.

Questions for Your Healthcare Provider

There are several questions that you should ask your healthcare provider about LEEP if you plan on becoming pregnant:

  • How do you think having a LEEP will affect my pregnancy?
  • Is 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? (The average time to wait before having sex is about four to six weeks. It may be more or less depending on how much cervical tissue needed to be removed.)
  • How long after a LEEP can I try to get pregnant?

Cervical Cancer Doctor Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

During Pregnancy

Be sure to inform your healthcare provider if you have had a LEEP at your first obstetrics appointment. Providing your healthcare provider with information, such as notes taken by the healthcare provider who performed the LEEP and the associated pathology reports, will help them determine the best way to manage your pregnancy.

Summary

LEEP is a procedure used to treat abnormal cells on the cervix. While it is effective, it does have potential future effects on pregnancy and birth for some people. Trouble getting pregnant, preterm birth, low birth weight, and miscarriage have all been associated with LEEP.

That being said, everyone is different. Talk with your healthcare provider about the risks associated with LEEP and your plans for pregnancy and childbirth.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nam KH, Kwon JY, Kim YH, Park YW. Pregnancy outcome after cervical conization: risk factors for preterm delivery and the efficacy of prophylactic cerclageJ Gynecol Oncol. 2010;21(4):225–229. doi:10.3802/jgo.2010.21.4.225

  2. Ciavattini A, Clemente N, Delli carpini G, et al. Loop electrosurgical excision procedure and risk of miscarriage. Fertil Steril. 2015;103(4):1043-8. doi:10.1016/j.fertnstert.2014.12.112

  3. Conner SN, Frey HA, Cahill AG, et al. Loop electrosurgical excision procedure and risk of preterm birth: A systematic review and meta-analysis. Obstet Gynecol. 2014;123(4): 752-761. doi: 10.1097/AOG.0000000000000174

  4. Jin G, LanLan Z, Li C, Dan Z. Pregnancy outcome following loop electrosurgical excision procedure (LEEP): A systematic review and meta-analysis. 2014. Archives of Gynecology and Obstetrics. 289: 85-99. doi: https://doi.org/10.1007/s00404-013-2955-0

  5. Johns Hopkins Medicine. Fertility and pregnancy after a LEEP.

  6. Kyrgiou M, Mitra A, Arbyn M, et al. Fertility and early pregnancy outcomes after treatment for cervical intraepithelial neoplasia: systematic review and meta-analysisBMJ. 2014;349:g6192. doi:10.1136/bmj.g6192

Additional Reading

By Jaime R. Herndon, MS, MPH
Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.

Originally written by Lisa Fayed