Dear Doctor,
I recently experienced a cornual ectopic pregnancy. After three doses of methotrexate my hcg level started coming down from 25,900 at it's highest to 48 a week ago over a two month period. Then last Monday it had gone back up to 61 so my RE suspects that there is some remaining tissue and I will be undergoing either a D&C or another dose of mtx.
In the meantime, I just got abnormal pap results back showing AGC and ASC. I had a colposcopy done on Monday and my cervix looked fine, but the OBGYN did an endometrial biopsy because of the AGC. I do not yet have those results back. I have had normal paps the last 5 years, but did have one other abnormal pap with ASCUS about 6 years ago. A colposcopy was done then that showed everything normal as well but my test came back hpv positive. Since then, I've had no abnormal results until this last one.
Is it possible that whatever is causing my hcg level not to drop to 0 is what caused the AGC on the pap, rather than precancerous cells? If so, would this show up very differently on the biopsy results just as products of conception or something like that? What type of followup would be recommended if this shows up as retained tissue since I will be taking care of that most likely with a D&C next week.
I have read quite a bit about how serious AGC can be and want to make sure I followup appropriately. At the same time, the ectopic pregnancy was the result of an IVF cycle and we are hoping to start our next cycle in April and due to my age (39), I don't want to delay it if it isn't necessary.
Any information you can provide would be greatly appreciated. Thank you so much!