Cervical Dysplasia again and trying to conceive

Hi, all. In 2000, I was diagnosed with severe dysplasia. Pap showed mild dysplasia and it was subsequently diagnosed as Cin III via colposcopy-guided biopsy. I had a leep a the time that showed clear margins. Interestingly, doc called me AFTER the leep and told me that the original biopsy was incorrect and it was only Cin II but treatment would have been the same (she said something about a classification system screwup). I should note that my husband's ex actually had cervical cancer so mine was likely a cancer-causing strain of hpv.

Anyway, for 10 years, I have had clear paps. In fact, last year, my hpv test was negative in addition to a clear pap. I am now in my late 30's and gave birth to a lovely daughter in 2002. my husband and I are currently seeking fertility treatment to have another baby and are literally days away from starting them.

So, had a routine pap two weeks ago at a new doc's office. Lo and behold, get the call that the pap showed lgsil (low grade squamous intraepithelial neoplasia). The nurse said mild dysplasia caused by HPV. They scheduled me for colposcopy/biopsy for 7/1. UGH! We have recently moved to a new area and this a new doc for me. In panic, I have called and set up a consult with my old doc for this Thursday. This feels like my first experience with dysplasia all over again. I am not sure what to do about our fertility plan, in fact, I could already be pregnant.

Anyone have anything like this happen? I thought after 10 years, I would finally be in the clear on a recurrence.

Thank you!

[Elaine Brown, MD]

Hi!
I expect that you may get many responses to your post, because I expect that many many women have had your experience.  Unfortunately HPV does act like this.  I had one patient who had a recurrence after 20 years.  Even though your paps were clean for all those years and your HPV test was negative, the virus was still present in your system, but your immune system was keeping it dormant.  Anything that affects the immune system ( for example pregnancy) can cause the HPV to be reactivated.

The doctor who did your pap was correct to schedule you for colposcopy, even though you maybe pregnant.  I personally don't do biopsies on my pregnant patients unless absolutely necessary, but I DO like to evaluate them carefully to rule out any possibility of cancer (very remote).

I'm happy that you are going to see your "old" doctor for consultation.  I would recommend that you proceed with your fertility work up.  HPV will have very little effect on the management or outcome of your pregnancy.

Do NOT forget to get your child(ren) vaccinated against this pesky virus!

Good luck!
Dr B