Brief Answer:
FOLLOW THE GUIDELINE.

Detailed Answer:
Hello,

Thanks for writing to us. Followings are my comments:

1) Your period cycle is overall regular according to your last 9 months period chart but you have light inter-menstrual bleeding or pink to brown discharge for last 2 months. Here, 1 to 7 days period date variation is quite normal and occurs mostly due to hormonal imbalance. However, we need to rule out the underlying causes of irregular bleeding in this context.

The cause could be Poly Cystic Ovary itself, cervical polyp or growth, pelvic or vaginal infection, over weight or obesity, mental stress, thyroid disturbance etc. Some additional test like hormone tests, blood sugar, vaginal swab test may be required for proper management of the case.

2) Red cervix is mostly suggestive of some inflammation of cervical cells and it may be due to bacterial infection, cervical polyp or growth, cervicitis, hormonal changes, contact with chemical subs etc.

Here, you must undergo scheduled Colposcopy as previous 2 smear tests were unable to report. Additionally, you do one HPV test to exclude relative risk and doubts regarding cervical pathology or growth. Proper treatment can be made after pinpointing the diagnosis.

3) You have to follow these suggestion for successful conception under the guidance of your gynecologist.

a) You need proper ovulation with regular cycle. You may require progesterone pill (D16 to D25) and ovulation induction drug (like clomephene) from D2 to D6 to facilitate chance of conception. Metformin is added to above treatment protocol to overcome insulin resistance. Kindly, procure a prescription from your doctor.

b) You should involve in unprotected sex close to ovulation time (14 days prior to due date) or fertile days (D10 to D23 of 26-34 days cycle) to maximize the chance of pregnancy. In addition, ovulation should be monitored in each cycle through serial ovarian follicular study (D12 to D20 in regular cycle) or you can use ovulation prediction kit (LH kit) in the mid-cycle.

c) You have to undergo some other fertility tests like husband semen analysis, test for tubal patency and cervical factors (like Anti Sperm Antibody, Post Coital Test), D-21 progesterone hormone assay, prolactin level test etc.

d) You must take a healthy balanced diet with more fresh fruits and vegetables. Low carbohydrate diet is preferable. Take vitamin-E and folic acid supplements for 3 months in preconception period and there after.

e) Do light exercise for overall physical fitness and control body weight. Avoid mental stress completely by regular meditation or yoga (15 to 30 min). Maintain genital hygiene properly.

Hope, I have answered your query. If you need any clarification, you can freely ask me.

Wish your good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through
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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up queries.

1) If your ovulation occurs properly in spite of having poly cystic ovary, then you have greater chance of being pregnant naturally. As your period is quite regular, then hopefully you ovulate timely. You can track down your ovulation day by using ovulation prediction kit (LH Kit) in the mid cycle to maximize the chance of pregnancy.

2) I suggest you to avoid intercourse till the problem is completely resolved as inflamed cervix (reddish color) due to bacterial infection or other causes (if any) may reduce the chance of conception by inhibiting entry of sperm inside cervix. It should be treated properly before trying to conceive.

3) You must undergo Colposcopy Examination for proper diagnosis of the case and treatment after that before planning for baby. Until then, you should wait for intercourse.

Colposcopy is a diagnostic tool to examine an illuminated, magnified view of the cervix and the tissues of the vagina & vulva. Many premalignant and malignant lesions in these areas can be detected through the examination.

A specialized colposcope equipped with a camera is used for examination. In this method, mild pain or bleeding may occur due to insertion of the device inside vagina. However, there is no serious complication and you wouldn't be worried.

Hope, I have guided you properly. If you don't have any other query, you can close the discussion.

All the best. Good luck.

Regards,
Dr Soumen

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