id. Orosz, László

Jakab, Attila

Juhász, Alpár Gábor

Molnár, Szabolcs

Török, Péter

Gynecological Surgery

University of Debrecen Electronic Archive

 
 
ES24-0146 
Selected Posters 
 
Effect of Endometrial Polyps, Histology, Intrauterine Localization and the Technique of 
Polypectomy On Fertility 
S. Molnar1, P. Torok1, A.G. Juhasz1, L. Orosz1, A. Jakab1 
1University of Debrecen, Institute of Obstetrics and Gynecology, Debrecen, Hungary  
 
Background 
Endometrial polyps are frequently found in infertile patients, but most of them are asymptomatic. 
They can be effectively detected by ultrasound using contrast media or color Doppler, but the 
gold standard is hysteroscopy. In reproductive age, they carry low risk of malignancy. It is 
assumed that larger polyps hamper implantation. However, it is not clear yet, whether resection of 
all polyps necessarily improves the fertility, and is the polyp localization influence the implantation 
failure. 
Methods 
A retrospective study of ovulatory infertile women with endometrial polyp, at whom TCRP was 
performed between 2006 and 2012. Time interval between operation and the first pregnancy 
were registered, if pregnancy occured until 2014. The aim was to evaluate whether the 
transcervical resection of endometrial polyps (TCRP) improves the fertility status, and polyp 
histology, intrauterine location, the technique of polypectomy have influence of pregnancy rate 
(PR) in ovulatory infertile women. 
Results 
Fifty patients were eligible for data collection. Anovulation, tubal, male factor were excluded. 
TCRP was performed by resectoscop or hysteroscopically controlled curettage, hystology was 
examined. Polyps were categorized to localization: utero-tubal junction, anterior, posterior, lateral, 
multiple. PR was calculated to TCRP method, histology and location. T-test was used for 
differences. Twenty-seven pregnancies (54%) were registered after TCRP, 20 (40%) of them in 
one year. Mean time interval until conception was 12,1 (range 3-41) months. PR was similar in 
resectoscop and curettage group (21/37, 56% vs. 6/13, 46%). To histology, PR was higher if 
simple polyp was found than after polyps with hyperplasia (24/37, 65% vs. 3/13, 23%, P=0.008). 
There were no differences in PR, neither in time interval to conception between the groups of 
different polyplocalisation. 
Conclusions 
Removing of endometrial polyps by TCRP improves the fertility of ovulatory women, irrespective 
to the resection method, i.e. resectoscop or hysteroscopy controlled curettage. Pregnancy rate is 
higher if endometrial hyperplasia is not found in the polyp. The location of endometrial polyp in 
the uterine cavity does not influence the fertility. Our data supports the hypothesis, that 
endometrial polyps physically prevent the implantation and can be the single cause of infertility. 
Thus, TCRP is recommended, irrespective to polyp localization. Resectoscopy is not superior 
than histeroscopically controlled curettage. Fertility prognosis is worse if hyperplasia is present, 
otherwise the one-year PR is good. Although the minimum follow up was 2 years, longer 
postoperative follow and larger patients number may alter the pregnacy rates. Influence of polyp 
size was not examined. Fertility related life-style and enviromental factors were not examined. 
 
 
 
S315Gynecol Surg (2015) 12 (Suppl 1): S1–S494


Effect of endometrial polyps, histology, intrauterine localization and the technique of polypectomy On Fertility

https://dea.lib.unideb.hu/dea/bitstream/2437/220490/1/file_up_2015GynecolSurg_ESGE_MSZabstract.pdf

Effect of endometrial polyps, histology, intrauterine localization and the technique of polypectomy On Fertility

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