When a biopsy taken at colposcopy shows high-grade cell changes, the usual recommendation is to remove that area. The most common method is a loop electrosurgical excision procedure, known as LEEP. A cone biopsy, which removes a cone-shaped piece of the cervix with a blade, is used when a deeper or wider sample is needed.
The procedure is usually done as an outpatient and does not take long, with local anaesthetic injected into the cervix. Most women feel period-like cramping during it. Afterwards, light bleeding and discharge can continue for two to four weeks. Doctors usually advise avoiding sex, tampons and swimming during that time to reduce the chance of infection.
Questions about pregnancy belong in the conversation before the procedure rather than after it. Removing a larger amount of cervical tissue, or having the procedure more than once, is associated with an increased chance of preterm birth in a later pregnancy. The size and depth of tissue removed is something your doctor weighs against the severity of the cell changes found. If you are still planning a pregnancy, say so clearly at the outset so it forms part of the decision.
Follow-up remains necessary afterwards, because removing abnormal cells does not clear HPV from the body. A repeat test is usually arranged six to twelve months later, and women who have been treated often stay on a more frequent screening schedule than the general population for several years.
See a doctor to discuss your plans for pregnancy before agreeing to the procedure, and contact the clinic sooner afterwards if you have bleeding heavier than a normal period, a fever, or discharge with an unusual smell.