Gynaecological Polyps Causing Infertility - a systemic review

Abstract

Background: Polyps of female reproductive tract are found in about 7.8-50% of women. Endometrial polyps are commonly located at the fundal or the tubocornual region. They mechanically affect female’s fertility and disturbs the normal cellular function due to chronic inflammation. To rule out sub clinical endometrial hyperplasia or cancer, endometrial curettage is often recommended. Cervical polyps may grow during pregnancy or mucorrhoea. Aim: To highlight updates to the epidemiology, clinical presentation and diagnostic techniques for gynaecological polyps. Study design: Systemic review Methods: During December 2020 we searched Google scholar, Pub med, Medscape, Web of Science, Scientific Information Database and Magiran research articles from 2010 -2020. The selected articles identified through electronic search were 60 articles and 50 were selected for the review. Results: Endometrial polyps are the most frequently diagnosed gynaecological polyp, their prevalence ranging from 7.8% to 50%. They are implicated in about 50% of cases of abnormal uterine bleeding and 35% of patients presenting with infertility. The developments of high-resolution 2D and 4D ultrasound, contrast enhanced sonography and hysteroscopy helps in diagnosing polyps efficiently. In certain cases, when hysteroscopy cannot be performed sonohysterography and ultrasonography can be used for screening. Hysteroscopy is the gold standard technique for the diagnosis of gynaecological polyps and histopathology is essential for the ultimate diagnosis and exclusion of malignancy. Conclusions: The review of literature suggest that the gynaecological polyps are one of the most common cause of abnormal uterine bleeding and have strong association with infertility as they interfere with implantation of an embryo. Polyps can be confidently diagnosed on ultrasound. Other imaging techniques may provide additional information about the details of the anatomy of female reproductive tract and the polyp itself. Keywords: Endometrial polyp, Cervical polyp, Vaginal/vulvar polyp, Infertility, Ultrasonography, Sonohysterography,.