Cone Biopsy Alternatives and Future Pregnancy

Patient: My gynecologist has strongly suggested I get a cone biopsy but I am wondering if other alternatives exist because I am worried about some of the possible side-effects. I am 30 and recently had an abnormal pap. I transmitted HPV/warts when I was 17 and had an abnormal pap followed by a colposcopy and a LEEP at that time. After that I have had regular paps every six months to a year. They have all been normal since except this last one ­čÖü I recently got married and my husband and I have been trying to conceive. I understand having a cone biopsy would increase my risk for having a miscarriage or preterm delivery. I DO NOT want this. My husband is also concerned about the procedure and wants me to get a second opinion. The gyno has informed me my pap came back stage III or severe. When I recently had a colposcopy the gyno did not see anything suspicious but she is concerned that I have severe dysplasia deep inside the opening of my cervix and that is why the colposcopy didn’t show any visible signs and the cone biopsy is recommended. Any suggestions on alternative treatments would be helpful. Or let me know if you think the wisest course of action would be to go ahead with cone biopsy. Thanks!

Doctor: It is true that miscarriages and preterm labor are recognized side-effects of a cone biopsy. However, you mention that y our Pap smear results show a stage III changes. The current recommendation for this condition is a cone biopsy. This procedure provides a complete cure. There are no alternative procedures that can be done that will offer a cure.The procedure can be performed in such a manner as to preserve as much of the cervix as possible to reduce the risk of miscarriage during pregnancy.