### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My wife (26 y/o, non-smoking, normal BMI) was on anovulatory for 2 years, suspected PCOS, not responded to Clomifene and was put on Gunal-F for 2 months when we were trying for a baby. One follicle matured after she was given an LH surge, but we did not conceive. This was four months ago. In the past couple of months she s had spotting/bleeding every two weeks or so which she attributed to her body trying to ovulate on its own. After 2 months of having spotting every couple of weeks, she went last week to her consultant who said that was cervical bleeding, and run a pap smear test. Results are only due in a week s time and she s very concerned about cervical cancer. 12 months ago HPV tests were borderline but smear test was negative. 1) what could be causing her cervical bleeding other than cervical cancer? 2) could it be connected to the infertility / rFSH injections? 3) in what % of patients does cervical cancer develop to an invasive stage within a 12-month period? many thanks in advance,a worried husband

### output:

Hello there, thanks for writing in. I understand your anxiety about your wife s health. Let me explain you to help you relax a bit1. Cervical bleeding can be caused by many reasons other than cervical cancer. A non-specific ulcer at the cervix, an endometrial polyp or a fibroid polyp protruding out from cervix and some infections that can be transmitted by intercourse.2. No, it is most unlikely, and it is not related to your fertility treatment.3. As the smear test is negative, and HPV tests are inconclusive, the possibility of cervical cancer at the moment is less. And if HPV test is positive, as your wife is young, you can expect the infection to fade off in some time. Having said that I would suggest you to get your wife evaluated by a good gynecologist to fix the cause of bleeding and for further follow-ups of smear test at 6 or 12-month intervals. Hope this helps a bit. Take care.