What's next after 4 LLETZ?

I've had LLETZ treatment four times with the most recent in Feb of this year. My latest smear at my 6 month checkup has come back as moderate again (although last time turned out to be CIN1 which was incompletely excised at the ectocervical margin during treatment). My whole situation is complex as I was due to have an abdominal stitch placed on the 7th Sept pre-IVF (to start in Oct).

With this latest news I've been advised to delay surgery until having a follow-up colposcopy on the 11th Sept and then discuss what my options are. I'm well aware that further treatment is almost 100% likely. Has anyone else been in a similar situation? I have already been told that after 4 LLETZ there is hardly any cervix left so am a bit confused about how they can do a standard LLETZ again to treat the abnormal cells this time. I know I carry high risk strains of HPV and this thing clearly isn't going away, having had my first treatment in about 2006. Is a  trachelectomy likely to be my next option? It makes sense given that this would also include a stitch similar to the abdominal cerclage (TAC) /stitch that I was having anyway. 


I'm sorry you're going through this and have had four treatments so far. It's probably going to be trachelectomy they'll be looking at now, especially given how much they'll have taken so much of the cervix.

I've been offered a hysterectomy if/when cells progress again with me but it's not something I'm going through right now. I wanted to write because I understand what a nightmare situation this is. There are other ladies on here who've experience persistent/recurrent CIN and hopefully someone who's had the treatment will be along to respond to you soon.

All the best to you.

Hi Twlight12, thanks so much for your response. It really is a confusing and frustrating situation to be in. At this stage I feel like I can cope with a trach if that is my best option. I would hope that it gives me a longer window in which I can at least try to conceive/go through IVF without the 6 month smear/bad news cycle causing a constant interruption/headache/heartache. 

I'll keep my fingers crossed it doesn't come to a hysterectomy for you. 

If anyone else has any thoughts, I'd welcome them. Thanks.