Abstract
AimOur purpose is to investigate if transcervical resection of endometrial polyps improves the fertility in ovulatory infertile women, and whether polyp histology, intrauterine location, and the technique of polypectomy have any influence on the pregnancy rates.MethodsIn this retrospective study, clinical data of 87 ovulatory infertile women who underwent hysteroscopy and polypectomy, and their 12-month follow-up have been analyzed. Subgroups according to the method of polyp removal (resectoscope or curettage), the polyp localization (utero-tubal, anterior, posterior, lateral, multiple) and the histological result were interpreted.ResultsMean age of patients was 33.99 ± 4.24 years. There were no differences in the BMI and basal FSH levels between the subgroups. Pregnancy was recorded in 30 (34.5%) within the next 12 months without any difference between the subgroups of polypectomy method applied. Posterior wall polyp resection increased the pregnancy chance (OR 5.02), but no other differences were observed in 1-year pregnancy rates to other localizations. Removal of polyps which had normal endometrial histology had lower pregnancy rates as compared to that of polyps with hyperplasia or endometrial polyp histology results (OR 0.25).ConclusionsPolypectomy improved the conception rate in the subsequent year regardless of the intrauterine localization and the method of its surgical removal. Therefore, we can conclude that polypectomy should be considered in infertile women.
Highlights
Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (WHO)
We investigated if transcervical resection of endometrial polyp (TCRP) improves the fertility status, and whether polyp histology, intrauterine location, and the technique of polypectomy have any influence on the pregnancy rates (PR) in ovulatory infertile women
There is no robust evidence on their relation to female infertility, removal of endometrial polyps in subfertile women is being performed in many countries with the aim to improve the reproductive outcomes
Summary
Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (WHO). Endometrial polyps are thought to cause uterine factor infertility by disrupting the uterine. Endometrial polyps are common lesions both in reproductive and postmenopausal ages; they are tissue growths that occur in the uterine cavity, which mainly represents focal hyperplasia of the basal layer of endometrium [2]. It is composed of endometrial glands and stroma around a vascular axis of spiral arteries [3]. The pathogenesis of the polyps is not exactly identified; it is thought to be similar to endometrial hyperplasia. Endometrial polyps can be detected by ultrasonography, hysterosonography, hysterosalpingography, endometrial biopsy and uterine curettage,
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