Fertility and Pregnancy After a LEEP
Featured Expert
It’s natural for women who are considering the loop electrosurgical excision procedure (LEEP) to be worried about the impact on their fertility and future pregnancies. This common method of removing abnormal cells from the cervix to prevent cancer does carry some risks, although they’re rare. Lillian Chen, M.D., M.P.H., an assistant professor in the Department of Gynecology and Obstetrics, addresses the top questions women have about fertility and pregnancy after a LEEP.
Key Points
- Fertility is usually unaffected, and most women can get pregnant without difficulty after a LEEP.
- Cervical stenosis is a rare complication where scar tissue narrows the cervical opening and may affect periods or sperm passage, especially after multiple or extensive LEEP procedures.
- Sexual activity is avoided for four to six weeks after the LEEP procedure, and full cervical healing typically takes about six months before attempting pregnancy.
- Pregnancy outcomes are generally good, with no increased miscarriage risk; concerns like slow dilation or preterm birth are uncommon and more strongly linked to underlying cervical conditions than to the LEEP itself.
Can you get pregnant after a LEEP?
There’s a small risk of scar tissue forming over the cervical opening (called cervical stenosis) after a LEEP. If the cervical passageway is narrowed or closed, this can cause irregular or absent periods or prevent sperm from getting through the cervix into the uterus to fertilize an egg. Cervical stenosis occurs rarely, although it’s more likely to happen if a greater amount of tissue needs to be removed during the procedure, or if you’ve had more than one LEEP.
When can you start trying to conceive after a LEEP?
Immediate recovery takes about two to four weeks. Women should avoid sex or inserting anything into the vagina for four to six weeks. Full recovery of the cervix takes about six months, and if there is no evidence of cervical cancer, patients can try to conceive after this time.
How do you know the LEEP was effective?
To ensure that the abnormal cells have cleared, see your Gyn/Ob for a follow-up exam. Depending on the results of the pathology report, you may need additional testing such as:
- a repeat Pap test
- HPV testing
- endocervical curettage (a type of biopsy inside the cervix)
Can the LEEP affect pregnancy?
If your doctor discovers high-grade abnormal cells during pregnancy, you’ll have to wait until after giving birth to have the LEEP performed. Having a LEEP prior to pregnancy doesn’t increase the likelihood of miscarriage. The procedure can cause difficulty in the early stages of labor for a small number of women who develop cervical stenosis. Women with this condition can take longer to dilate than average, but a Gyn/Ob can use various methods to help stretch the cervix.
In the past, doctors would check the length of the cervix in women who’ve had a LEEP. That’s because they’re more likely to have a shortened cervix, depending on the depth of excision during the LEEP, which doctors thought could affect the ability of the cervix to stay closed during pregnancy, thus leading to preterm birth. However, recent studies indicate that cervical dysplasia — abnormal (precancerous) cells in the cervix caused by HPV — and other risk factors such as smoking are more strongly linked with preterm birth than the LEEP itself.
The Bottom Line About Fertility and LEEP
The LEEP is a safe and effective way to remove abnormal cells from the cervix, which could turn into cancer. There is rarely an impact on fertility and pregnancy after a LEEP. But you should always discuss any concerns you have with your doctor.
Medically reviewed by Lillian Chen, M.D., M.P.H.
About LEEP
LEEP is used to diagnose and treat abnormal or cancerous conditions in a woman's lower genital tract. Learn how the procedure is performed and the best ways to ease recovery.
