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Pregnancy After LEEP

Can LEEPs Cause Miscarriages? Will I Be Able to Get Pregnant After a LEEP?

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Updated May 27, 2008

When a woman has been recommended to have a LEEP to treat high risk cervical dysplasia, her first concern may be how the procedure will affect future pregnancies. Tales of sterility, miscarriage, and pre-term labor 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 -- an acronym used to describe loop electrosurgical excision procedure -- is a procedure done to treat persistent low grade dysplasia and high grade cervical dyplasia. It is also done if Pap results don't correspond with colposcopy and biopsy findings.

A LEEP uses an electrically charged wire loop to remove cervical tissue. It is done under local anesthesia and normally on an outpatient basis in hospitals or in the doctor's office.

The Risks of Pregnancy After LEEP

Risks associated with a pregnancy after LEEP include:
  • Cervical Stenosis. Cervical stenosis is the tightening and narrowing of the cervix. This can cause the cervix difficulty in dilating during labor. Once diagnosed, it can be corrected with gentle dilation. Cervical stenosis is also related to painful menstruation and infertility.

  • 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.

  • Infertility. Although extremely rare, a LEEP may cause a woman to become infertile. It is important to note that research on LEEP and fertility is very limited.

    A LEEP is a Safe and 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 these complications affect only one to two percent of women who have a LEEP, but there is a slightly elevated risk of pre-term labor. Most women do go on to have healthy pregnancies that go full term.

Talk to Your Doctor Before Having a LEEP

Your doctor is your greatest resource about how a LEEP will affect future pregnancies. Some question to keep in mind when talking to your doctor include:

  • How do you think a LEEP will affect a future pregnancy?
  • Is a LEEP the only treatment option I have?
  • How long will it take for my cervix to recover?
  • After the LEEP, how long should I wait to have sex?
  • Should I wait a period of time before getting pregnant?

Once You Become Pregnant

Don't forget to inform your doctor that 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 your pregnancy. Women with a history of having LEEP procedures undergo more frequent cervical exams during pregnancy.

Sources:

"Surgery." Cervical Cancer:Detailed Guide. 04 Aug 2006. American Cancer Society. Accessed 15 Jan 2008.
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_8.asp?sitearea=.

"Treatment Options by Stage." Cervical Cancer: Detailed Guide. 04 Aug 2006. American Cancer Society. Accessed 17 Jan 2008
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Treatment_Options_by_Stage_8.asp?sitearea=.

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

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