Hello,

I've been having irregular paps for about 16 months. They initially stabilized, then spiked up to the 3-D level during my last two paps. I'm CIN I. I live in Europe, so I'm not sure if the terminology is the same in the U.S.

In 10 days, my doctor expects to have the results of my most recent pap (pap #5 since I've been diagnosed with HPV). She says that if the pap results remain at the 3-D level for a third time, then she will advise that I have a LEEP procedure completed.

Trying to be a well-informed consumer, I contacted my insurance company, Aetna, today. I was pretty much shocked when Aetna told me that the LEEP procedure is considered to be 'experimental and investigational', essentially not covered by them!! In short, they do not deem it 'medically-necessary' for cervical dysplasia, abnormal cellular changes, what I deem to be pre-cancerous changes.

So my question is this. If the doctor's recommended LEEP procedure will not be covered by my insurance, what other surgical options do I have left? I'm 32, and hopeful that I can someday have children so it'd be nice to have an effective surgery that won't impact my ability to have kids.

I contacted an OBGYN's office in the States, and the doctor there was essentially shocked that a LEEP was classified as 'experimental' by Aetna.

Please advise.

Thanks so much.

I can't say I've ever heard LEEP referred to as "experimental," and am not sure what the basis would be for such an opinion. LEEP is certainly a tried and true tool used in clinical practice, and is a common treatment option with cervical cell changes are removed.

Beyond LEEP, cervical dysplasia is often treated through freezing the affected area (known as cryotherapy). Another procedure, where a cone-shaped area of tissue is excised (and appropriately enough referred to as cone biopsy) is sometimes used, but not so much with CIN 1. Read more about treatment options at http://www.ashastd.org/hpv/hpv_learn_dysplasia.cfm#6

I wish there were more I could offer! Let us know how things work out, if you don't mind.

Best,
Fredo

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