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Gynecology

Three leep procedures

09/18/2008

Question:

I have had three leep procedures as well as one of my ovaries removed due to a cyst. I am visiting my doctor every six months but I am concerned that another leep will seriously affect my chances of having children. My doctor mentioned that if I became pregnant he would measure my cervix and then make a determination. With three leeps in 6 six years I am concerned that there is no end in site and that there won`t be much a cervix left by the time I decide to have another child. What should my expectation be regarding the time frame that I may have left to have a healthy and normal pregnancy. I am 27 years old, have one child that was premature (I was 19) and lost one child because the doctor found he had no kidneys and I delivered at 6 months. Any help you can give me would be appreciated.

Answer:

A LEEP (loop electrode excision procedure) is a means of removing abnormal or dysplastic areas from the cervix that may be precancerous.  While highly effective in removing such abnormalities, there is a 10 - 15% chance that such an abnormal growth will recur, making another treatment necessary.

You are right to be concerned about the risk of pregnancy, since each LEEP procedure can shorten or weaken the cervix and make the chance of having a miscarriage or preterm delivery higher.  Sometimes a procedure early in pregnancy called a cerclage can be done to bolster the cervix and reduce this risk.  Given your history, it would be worthwhile to consult a high risk obstetrician when you get pregnant to discuss this option.  It would also be worthwhile to consult an expert in cervical disease or a gynecological oncologist before you have any other treatment of cervical disease.

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Response by:

Jonathan  A Schaffir, MD Jonathan A Schaffir, MD
Clnical Assistant Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University