Abnormal smear and pregnancy

[ThreeBees]

I've just had a "borderline" smear result (I presume CIN 1) with a request to come back in 6 months for a repeat. There are many reasons why I really want to be pregnant by then with DC2 (hormonal, financial, age, career).

What would you do? I have minor changes which will probably go away by themselves, but with maybe a 10% chance of them progressing into worse pre-cancerous changes. Do I continue TTC to then put my repeat smear off for another 6 months? Or do I wait for my repeat smear and then try and get preggers? Far later than I'd wanted for reasons above.

Does anyone have any experience of this?

Also, CIN3 is an abnormality of the entire thickness of (normally part of) the outer surface of the cervix, so is the most severe grade of CIN. It would therefore be reckless to get pregnant prior to getting this treated/confirmed at colpscopy and biopsy, but not so reckless to get pregnant prior to getting the all clear in relation to a report of borderline changes in cells.

Borderline changes is not the same as dyskaryosis, it is generally a minor abnormality that we prefer someone to come back early and have a couple of follow up samples.

Dyskaryosis is the term we use in cytology to describe the changes seen in the nuclei of abnormal cells.
CIN=cervical intraepithelial neoplasia and is the disease entity and the term used in histology to describe the abnormality seen there.
Cytology is where we look at cells and their structure/features in details under the microscope
Histology is more concerned with the overall structure of the tissue rather than individual cells.

A cervical 'smear' or Pap test contains cells scraped from the surface of the cervix. If you have a tissue sample removed by biopsy or LLETZ then the full thickness of the tissue can be examined - which you need to do for a complete assessment.
The cervical smear does give a good indication of what's going on but the differences between the sampling means the cytology and histology will not be exactly the same as you're working with subtley different techniques.

To go back to the OP - probably a good idea to see your GP.

I had dyskaryosis (mild) but by the time I had a colposcopy the cells had returned to normal ( I was pg so decided to wait as didn't want to risk the pregnancy). Strange, as was told by the gp that cells do not change back to normal after two abnormal results. But mine did.

I was told smears are not advisable in pregnancy because of unreliable results (cell changes during pg). Personally I'd always rather avoid any internal intervention that isn't absolutely necessary(due to having experienced several m/cs).

Hi threebees - i know exactly how you feel... I had a borderline smear this time last year (april 09) and held off trying for a baby just to be on the safe side...

6 months later my smear had returned to normal! yipee (and i also paid for a private one at the time as i couldnt bear to wait for the results!) so the private one was normal too...

just got my next results back - and it is borderline again... ggggrrrr it's so annoying... so actually i could have by now had a baby and be no worse off than i was this time last year! now i am thinking i might just start trying. If the next one were to come back normal, but then the following one borderline again it could go on for years. luckily i have one child already who is now 3 but i desparately want to start trying again.

my mum died of cervical cancer and so did her mum... so it is really hard to take the plunge and just get pregnant and purposfully miss a smear.

what a nightmare it is eh?!

hope you can decide what you're going to do x x x

treeze - same advice - go and talk to your GP about it. They can help you assess whats the best course of action. If you read my posts, you can see links to useful information about screening and borderline changes and what the result means.
HTH

Thanks again very much everyone.

Treeze, how annoying. That's the situation I can see myself getting into! Must be extra frustrating for you with your family history.

So here's what I've decided to do - try for the 2 months where there's a big financial gain, then if I'm not preggers by then, I'll wait for the next smear. I think (hope) the money is worth the risk. I at least want the chance at it.

Your thoughts are all very much appreciated xx

hi

thanks for the advice BelalugosiNoir... i spoke to my dr and am off to see them next week.

I forgot to say that when i went for my last smear they noticed i had cysts on my cervix too which they said were harmless but i'm going to get a 2nd opinion on those too.
Could the development of cysts on my cervix have produced the borderline result?

also both times i have had the borderline results i have been on antibiotics for a staph infection in my nose - do antibiotics affect smear results?

threebees - sounds like a good plan you have made! hope it all goes well - many people i have spoken to have said it is fine if you become pregnant as long as you go back for your smear asap afterwards... but although i know this i am still a bit worried about going for it!hope it all goes well for you...

hopefully by this time next week i will have been to the docs and have more information to help me decide what to do!

take care

treeze x x

I'm the same, we've just started trying and then got the news - same thing, borderline. I went to see the nurse and she's said it probably wouldn't be a problem if I got pregnant soon as it would only delay the repeat smear by a few months but maybe talk to the doctor.
I'm in a similar position, mid thirties and am finally entitled to maternity, so need to stay in my dreadful job if I plan to have a baby!!
Guess we need to make a decision!

just a quick update - went to see my doctor today and she was fantastic... due to family history and also beacuse of my worrying about the borderline results and cysts she is referring me for a colposcopy - she said that they might actually say no and decline a colposcopy, but that if they do then that would be a good indication (from the experts)that there is time to have a baby before anything else could develop...

if they agree to do the colp then they will either be able to say 100% it is ok go ahead to have baby or they would be able to do immediate treatment (although doc said she very much doubts there will be anything to treat).

So this is great news for me - the doctors have been fab and i am so pleased i rang them and asked to discuss it with a doctor - now i will either be treated much sooner than had i waited for the next smear... OR i will be given a consultants "go ahead" to try for another baby! yipee! am also cutting out alcohol and taking vitamins, as well as eating really healthily - the doctor said that low immune / infections can also be a contributing factor to abnormal smear results.

oh well just thought i would share that with you all - DEFO worth following up with your doctors and asking their advice about concerns you have. They were also able to advise me today that my smear results showed no sign of HPV virus, and that it was only "some" of the cells which were borderline (not all of them) - which has eased my mind a bit too.... i never would have found this out if i hadn't rung them back after getting my results and asking if there was someone i could talk to x x x

Hi treeze
Very pleased to hear about the support you're getting from the GP. This is how things should work.
I can tell you what I know from the cervical screening lab but it's no substititute (nor should it be!) seeing a clinician who knows your circumstances.
To come back to your query about what causes borderline results, there are a few things:

borderline changes means there are cells which have changes that aren't quite enough to be definitely abnormal but aren't quite right to be definitely normal.
They are often due to things such as hormones, ICUD/IUD use or infections such as Candida (Thrush) or HPV. Basically the abnormal cells are very active , and conditions such as I just mentioned can also make the cells quite active.
Because there's a slight overlap we ask people to come back again in 6 months because the body/cervix has often settled down and the majority of the time go away on it's own, a bit the like the body dealing with a cold.
The average sample that we read contains about 100,000 cells. Often there's only 100 of those which are abnormal. Sometimes it's as few as 5! This is why reading Pap tests has been compared to spotting a needle in a group of haystacks from an aeroplane!

I think in your particular circumstances, colposcopy referral esp as it will help to put your mind at ease then is probably the best course of action. I hope it goes well.

To Lunatic Fringe - see my reply of Wed 07-Apr-10 22:15:44, re having smears in pregnancy.

Threebees - this is a little late in the day and you have probably made your decision. But the same thing happened to me. I got a smear and various inoculations before ttc. I had a pos smear test and found to have CIN1 following a colposcopy . I had the choice of going for an op or waiting to see if it would go away which kinda put the ttc up in the air. I decided to continue ttc and I am glad I did as it has taken a lot longer hat I hoped to get pg, this is month 10 of trying (hopefully last) and in that time I had another smear test which was normal.

Good luck!

Hello

Just having a trawl to see if Treeze is still about - did you have your colposcopy? How are you getting on?

I have managed to get myself pregnant. So I suspect I'll be waiting til afterwards for my repeat smear! I'll see what the midwife says.

I won't deny I'm slightly nervous about it all, but I made the choice in full knowledge of the risks, so I'm just going to suck it up!

Hope you are all well xx

Congratulations, ThreeBees! That's exciting news! I think you did the right thing.

ooh, I wondered about you, congrats.

Hi there threebees(and everyone else!)... awh thanks for thinking of me... and big congratulations - thats fantastic news!

well it took a few weeks to hear about whether they would do a colposcopy but about 2 weeks ago i got a letter with an appointment.

So last week i went to their clinic and they were SO good. The consultant explained all the procedure really well and it didn't hurt at all. In fact it was easier than have a smear (i think because you are in a better position in the reclining chair they have). I could see everything she was doing on the tv screen which was a bit weird. She used 2 different solutions to check for any abnormalities but she said it all looks completely normal!!!! No need for a biopsy. what a relief...

the whole thing took about 5 minutes. And then they said "we'll see you again in a year for another one just to keep an eye on you" which i think is fantastic. I can now relax knowing that everything is ok at the moment. They said it is fine to try for a baby (and that they would say the same for anyone with a borderline result). If i am pregnant this time next year they said they will see me 3 months after the baby is born.

So i think we will start trying now and see what happens!!! yipeee!

will keep you all updated in the future!

treeze x x x

excellent, glad it went well

I had an abnormal smear test in November 2009 - followed by a coloscopy in Jan 2010 - the result stated ' the laboratory report on the portion of cervical tissue removed showed moderate and severe pre-cancerous cells CIN2 and CIN3. I am pleased to tell you that there was no evidence of any cancer and the abnormal area was removed'.

I then had a follow up smear in Jul 2010 - I have just had the results and this now advised that I have 'borderline changes' and need to go for another smear - this is not until Jan 2011.

Me and my husband had planned that we would start a family after Christmas 2009 - with the smear results we had put this off.

I am 33 and desperate to start a family - and the thought of waiting another year (by the time I have repeat smears another 6 mths after Jan 2011 as well) is killing me.

I am worried that if i ask the nurse or doctor they will just point blank say we shouldnt try...

I am so confused - part of me wants to try and get pregnant - see if we are by November if we are great, if we are not just put on hold until after the January smear test.

Its just so hard and the waiting is a huge stress on both of us.

I mean what is the worst that could happen if I delayed the nest smear by a few months - could I get cancer? Am I risking my life - I just want mine and my husbands life to be complete.

The above thread discussed this issue. I linked to the guidelines around follow-up after abnormal tests (see BelaLugosiNoir Wed 07-Apr-10 22:15:44).
I gave info at this post BelaLugosiNoir Wed 12-May-10 21:26:50 on the common reasons for borderline changes.
No-one on here can say for certain whether it is safe for you to delay the follow up test.
As with the other posters, the best advice is to contact your GP and/or gynaecologist as they can advise you based on your specific history.

hi i have been told i have got moderate dyskaryosis and have been sent to the hospital for a colposcopy which i have not been for yet but i was wanting to know if any one knew how long after treatment can i start trying for a baby as me and my patner were talking about trying to start tryin.
if anyone knows please can you let me know

Hi emmaplus3 - it depends on your specific circumstances, so you will need to discuss it with the colposcopy staff at your appointment. Once they have been able to have a better look at your cervix, they'll be able to tell you if you need treatment and what sort. Then they'll be able to say when you should be ok to TTC.
Also have a look at the BSCC website which has info for women about colposcopy and treatment.

hi BelaLugosiinStripes sorry was not sure which thread i was on mind not what it was thankyou for the advice

Hi
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Hope your appointment goes well, all the best.