Home Colposcopies and pregnancy

[Izzy03]

I know that I am probably freaking out more than I should, but I am having some trouble finding information over the internet and knew I could turn to PS for comfort/advice.

I just had my second colposcopy performed two days ago and the though just popped into my head........ what are the chances that all this could affect my ability to conceive/carry in the future? What if I do have to have a LEEP or other procedure performed, how could those affect this?

Some background info: My mom had GREAT difficulty having children. She had severe endemetriosis, and after 5 years of trying to conceive, she finally gave up and adopted my brother. About a year after adopting, she became pregnant with me, which came as a huge surprise because she didn''t think she would ever conceive. At the young age of 36 she had to have a hysterectomy.

When I mentioned Mom that I had two pap smears come back abnormal and had to have biopsies she was not very comforting. I believe her response was "I have NEVER in my life had an abnormal pap!" Thanks mom, as if I wasn''t already feeling "abnormal" enough (sorry, I can never resist a good pun)! I think I will stick to the internet for my gyno advice for now!

About the time I turned 17, my "normal" menstrual cramps starting to get pretty severe, so my doctor putting me on birth control as a precaution because I was too young to have the laproscopic surgery to diagnose edomedriosis. I have been fine on birth control ever since but I have tried to stop taking it a few times and the cramps were bad enough for me to get right back on it!

ANYWAYS, with my mom''s history I have always been a little nervous that I might have inherited the "bad conceiving gene". That in addition to my recent gynocological produres, have me slightly panicked. I am getting married in about 6 months, so my fiance and I have had some "baby timeline" discussions.

Sorry for the long (and very detailed post) I guess the only thing you don''t know about me now is my shoe size!

Any information, or personal experiences would greatly ease my mind. THANKS IN ADVANCE!!!!

 

[Pandora II]

I can''t give you any advice on the coloscopy issue, but if you and your FH are hoping to TTC quite soon you might want to go and see a doctor about coming off BC and seeing how your cycle looks and resolving any problems that there might be early on.

 

[Independent Gal]

hi izzy! maybe i can help a little. first of all, you're upset is probably at least in part due to the fact that it is icky to feel like you are "abnormal". but guess what? every last human being on the planet, except maybe the odd newborn, is completely crawling in viruses and bacteria. and pretty much all of us have some varieties of the hpv virus, some strands of which causes warts on your fingers, feet, elsewhere, other strands of which cause those little skin tags that pretty much half of people have, and lots of other strands don't cause any externally visible effects. a few strands cause cervical abnormalities, but estimates are that about half of the general population has that strand, whether or not it causes cervical chances. so honey, since we all (or nearly all) have at least one strand of this (more likely more like 10 or 20 strands) in our bodies, and a large minority or small majority have the one that sometimes causes cell changes on the cervix, you are NOT ABNORMAL!!!!!

What you are is lucky. Because catching changes early = no cancer. Cervical cancer used to be a leading cause of death in women, often at a young age. NOw that we can detect cell changes early and get rid of them, the rate of cervical cancer deaths is dramatically diminished.

And yes, they think that hpv and other viruses might cause other cancers as well. Cool, because then we can be immunized against cancers.

OK, so now that you know that you are normal.

re pregnancy.

cone biopsy (pretty much nobody does these anymore, they use other biopsy techniques...but double check that that's not what they did) = BAD
LEEP = not great

These two things can weaken your cervix. It won't keep you from getting pregnant, though a cone biopsy can make it marginally harder (since the caves where the boy-cells like to hide to wait for the egg sometimes get damaged) and won't necessarily keep you from carrying to term. but it does increase the risk of cervical problems that make it hard for you to keep the baby in there to term. You may end up needing a cervical cerclage to help out with this. Vee have vays of keeping your baby in there, if the problem even arises to begin with. It's a question of probabilities, not certainties.

So. Don't panic! because the chances they did a cone biopsy are teensy, and there is an alternative to LEEP that doesn't really result in problems for the cervix. So demand that procedure instead and you're golden.

Freezing procedure to get rid of cells = no big deal.

So, your job is to advocate for yourself. Make clear you want kids and you want to absolutely minimize the chances of jeopardizing carrying a pregnancy to term. Insist on the freezing procedure. And if for some medical reason you relaly need LEEP, then just remember that it makes things riskier, but doesn't doom you. And there are ways to strengthen your cervix while you're prego so that it will more likely be ok.

Hope that helps. Now stop panicking! Get that cervix fixed up! And talk to your doc about your endometriosis worries. That's a completely separate issue, by the way. But there may well be plenty of technology to keep it from mattering these days. Who knows?

But seriously, don't panic. Talk to your doctor. Get information and research, not horror stories from the internet. Be proactive, informed, and advocate for yourself.

 

[jas]

I''ve had it all -- colpo, LEEP, 8 gazillion "abnormal" paps...and healthy babies (at advanced maternal age, thank you.)

I literally had to go against my nature and STOP researching every procedure (beyond basic stuff)...it was hard but I chose to just focus on the basics (here''s what happens during, here''s what procedure will be, etc.) and move on.

Ab. paps stink, but my dr. says I will prob. always have higher-than-normal numbers.

I like to think of myself as a gynecological overachiever.

It''s not unheard of to be ok after all this -- HUGS to you!!!

 

[Independent Gal]

Date: 9/21/2008 8:21:34 AM
Author: jas
I''ve had it all -- colpo, LEEP, 8 gazillion ''abnormal'' paps...and healthy babies (at advanced maternal age, thank you.)

I like to think of myself as a gynecological overachiever.

and jas had twins! go cervix go!

see? she really is a gynecological overachiever.

 

[dani13]

Hi Izzy,

I just wanted to let you know, first of all, you are not ABNORMAL at all....HPV ( the virus that can cause abnormal cells to grow on your cervix, and other areas) is extremely common!!!! Indy did a good job explaining things, but I also wanted to add that significant research has been done studying the connection between cervical dysplasia procedures (colpo's/cones/cryo's/LEEP's) and effects on future pregnancies. Researchers have NOT found a strong correlation between these procedures and future fertility, impact on future pregnancies (including spontaneous abortion (miscarriage) and preterm labor). So, please, put your worries at rest!!!!!

Depending on the results of the colposcopy, your MD/provider will decide what to do next. If you do end up needing a procedure to remove a bit more of the cells, such as a cryosurgery (freezing of the cervix), that's no biggie. However, if the cells are more highly abnormal, they may proceed with something called a LEEP procedure, which will remove more of those "bad cells" on the cervix.

Even though research has shown that there is not a strong connection between LEEP's and preterm labor, if a patient does have a history of LEEP procedure and becomes pregnant, we do have her cervical length checked more frequently than a patient without a history of LEEP. Its just a precaution for women that have had a more invasive procedure performed on their cervix. The reason for checking the cervical length more frequently is that if we see the cervix thinning and/or shorterning at the patient's routine scans, we can hopefully prevent the sequelae of a possible preterm labor/incompetent cervix situation.

Hopefully, things for you will stop here. But just remember-this is not the end of the world, you are not abnormal, and its going to be ok!!!!!!

Good luck!!!

 

[Pandora II]

Date: 9/21/2008 7:44:24 AM
Author: Pandora II
I can''t give you any advice on the coloscopy issue, but if you and your FH are hoping to TTC quite soon you might want to go and see a doctor about coming off BC and seeing how your cycle looks and resolving any problems that there might be early on.

Ooops, ignore everything I''ve said.

I misread and thought it was a colonoscopy - makes rather a big difference... sorry!

 

[curlygirl]

Izzy, I've had 3 LEEPs over the course of 10 years and I'm 39 weeks pregnant with my 2nd child right now. I had no problems the first time around, my cervix was actually longer than some people who have NEVER had any kind of cervical procedures! This time around, once again, there have been no issues and clearly, since I've made it to this point with absolutely no problems, preterm labor was never a thought. I'm starting to think I may go over my due date!! Did I mention I had my first child at 36 and am now 37?! So I'm considered "old" in the medical world, I didn't give my body a long rest period between pregnancies and everything is fine. Like Dani said, your cervix will be monitored more closely and you will frankly be happy to have the extra ultrasounds!

You can do tons of research and make yourself crazy or you can just stay on top of your situation and talk to your doctor about your concerns about conceiving and carrying a baby to full term. If your doctor doesn't do too much damage to your cervix with whatever procedure you end up with, you should be fine--make sure you are seeing someone who specializes in these procedures. My OB was actually shocked the first time she checked me out because she said there was absolutely no evidence that my cervix had been tampered with!! So I think it really makes a difference if you have a doctor who is an expert at these procedures rather than just a regular gyno. Jas and I are living proof that you can go on to have a normal life after being considered "abnormal"!

Good luck to you and please keep us posted!!

 

[vespergirl]

I''ve had a LEEP procedure, and it had absolutely no affect on my ability to conceive - if anything, I became unexpectedly pregnant about 1.5 years after the procedure.

The problems could start once the baby starts getting bigger, though. Since I had had a LEEP, I had to go the OB/GYN to get checked out every 2 weeks during my pregnancy and then every week in the last month because of the chance of "incompetent cervix." Since a LEEP removes a small piece of your cervix, it could make it less strong, and less able to hold the baby inside the uterus - my dr. said my chances of a late-term miscarriage were higher.

However, throughout all the checkups, the baby stayed WAY up there, there was no sign of premature labor, ever. If anything, when my water broke 4 days before my due date, I STILL didn''t go into labor, and I eventually had to get induced, and the baby was assisted out by suction, because he wanted to stay up in there. So for me, the small chance of cervical incompetence that comes with having a LEEP procedure did not affect my pregnancy or delivery at all.

 

[Izzy03]

Thank you all for sharing your stories. It really sounds like a rare problem that occurs, and it is good to know that there are treatments available if necessary. I will be sure to discuss this with my OBGYN if my problems progress.

Reading risks factors on the internet can be so scary, so it is great to hear first-hand experiences. Nothing beats it! You all rock!

 

[Independent Gal]

Izzy, this is why statistics can be so important. For example, monochorionic twins (my kind) have a 400% higher chance of serious heart defects than other babies. But you know what? The risk of serious heart defects in general is so small, that 4 times that number is STILL small. Way too small to really worry over. So whenever a newspaper article or internet site screams "X INCREASES YOUR RISK OF Y" it always pays to find out how big your risk was in the first place, and how much the risk is increased. Say your risk was .01% and now it''s .1% (1 in a 1000)... really, are you going to worry about that?

Personal stories can help too, but it''s just easy to get bogged down by worrying abou that 1 in 1000 story as to be comforted by the 999 happy stories, so you should really be wary of taking peoples sad stories on the internet. People are more likely to go to the internet with something that went wrong than something that went right, so you get a very skewed sample.

 

[Clairitek]

Izzy- I can imagine that you and I are about the same age (early to mid 20s?) and I too have had many abnormal paps. It started about 3 years ago when I had low grade squamous cells on my test results. I had a colposcopy and a biopsy and everything turned out OK- no cancer or anything but my doctor did tell me that I had HPV. This was before HPV became so publicly acknowledged so I sorta freaked out upon hearing it. This was also prior to the vaccine being released. I remember thinking "WHAT? ME? HPV? I''m careful! How did this happen to ME?!?!?" and my mother didn''t have the best reaction at first either. Her response was "If you''re careful, how did you get this?" Then I told her that 80% of women who have had 3 partners or more have contracted HPV. They might not be as affected by it as you and me but they have it. Once I told her that and how her comments made me feel she apologized. I hope that your mom does the same.

This past May, after 1 biopsy, 2 colposcopies (they didn''t take tissue the second time), 1 cryotherapy session, and countless paps I had my first happy, clear pap in 3 years.

I actually cried the day that the nurse called me from my school''s health center to tell me that my results came back clear. My mom cried too. She was just relieved that she wouldn''t have to worry about me anymore.

So I hope my story gives you some hope that this will probably pass, so long as you keep on top of getting paps and tracking your progress. I have other friends who have been in the same situation as me and have eventually had clear paps following cryotherapy.

Also- not once this whole time has my doctor mentioned that this could decrease my chances in conceiving and carrying a child.

Have you gotten the HPV vaccine? I went ahead and got it even though I had already contracted one strain that had affected my cervix. It couldn''t hurt to get it (well, the shot hurts like hell but you know what I mean) now especially if you have health insurance that covers the cost.

 

[MMMD]

Hi Izzy. My story is a lot like yours. My mother had trouble conceiving and carrying babies but managed to have my sister and I and then a hysterectomy at 30. Thank goodness she was married at 20 and started trying right away to have children otherwise I might not be here typing this. Anyway, I got pregnant 1st try at 33 years old but PAP showed abnormal and I had to have several colposcopies. My doctors were good about checking my cervix frequently during the latter stages of the pregnancy. I delivered at 42 weeks so no problems!! I went on to have another daughter 3 years later, needed one colposcopy early on but no problems at all with pregnancy.

Good luck, try not to worry.

 

[Izzy03]

Clairitek: Yes we have a very similar story, early to mid 20s. Definitely how could this happen to me?! My first abnormal pap was in February, a colposcopy and biopsy two weeks later, and a repeat pap last month. My doctor told me that my most recent pap looked better and appeared as if things were resolving. So you can imagine my surprise when she said she wanted to do another colposcopy anyway. Then there was even more surprise during the colposcopy when she said a larger area of my cervix looked affected. I go in for my results on Oct 3 and I guess I go from there. I think I have prepared myself a little in case I do need freezing or a LEEP. I will be sure to discuss my fertility concerns with her!

MMMD: Colposcopies during pregnancy? Oh wow, shoot me now. You are my hero!

Update: I was planning on leaving my job in next couple of months to begin preparing for my wedding, and moving to where my fiance lives, but now I have to continue working because of my medical issues. I am going to ask my doctor if my next pap can wait til April, when I am married and have my fiance''s insurance (depending on my biopsy results of course).

 

[Clairitek]

The cryotherapy isn''t the end of the world. It just felt like the worst cramps I''d ever experienced in my life for 5 straight minutes. I am a weenie when it comes to gyno pain so it probably isn''t even that bad for most. I had to wear a pad for the next month plus but now I am so grateful for it. I will warn you though- I was under the impression that the cryotherapy would have immediate effects on my paps and cervix. It took me 2 more paps (6 and 12 months post-cryotherapy) to have a clear one.

I can also relate to the insurance thing. I am off of my parent''s insurance at the end of this year. I''ve managed to prolong my coverage with them by becoming a lifetime student. My FF and I actually discussed getting married for the purpose of benefits but lucky for me I can get some inexpensive (and I''m sure not close to the same coverage I have now) insurance through my graduate school.

I hope you''re able to work things out so you can do what you had originally planned and leave your job earlier than April. I bet you can''t wait to move closer to your FI.

Good luck with all of this and just remember that you''re not alone!

 

[MMMD]

Izzy I can''t be your hero because, I have to admit, I really wasn''t in any real pain. Even when I had the freezing done in between my pregnancies I was uncomfortable but nothing terrible. The worst for me was waiting for the results. But all of my many PAPs since April of 2001 have come back clear.

It stinks but you are going to have to keep your insurance until you are finished with procedures.

 

[Kay]

Izzy, I can''t comment on the other procedures, but I had a colposcopy with biopsies about six months before becoming pregnant with my first child at age 36. I am 37 weeks pregnant now, with no problems so far. You should have a long talk with your GYN about your concerns and when you should get off BCP before TTC.