It is estimated that between 8 and 12% of women will develop endometrial polyps during their reproductive years. These represent outgrowths of the uterine lining that can vary in shape and size but reflect uneven development of the tissue that is responsible for promoting implantation of embryos to initiate pregnancy. Therefore, it’s not surprising that they seem to be more common in women with infertility. In fact, one study of 1000 women undergoing IVF found about 32% of them had endometrial polyps.
In an attempt to estimate the impact of endometrial polyps on infertility, one study randomized 215 women with endometrial polyps to having surgery prior to starting Ovulation Induction with Insemination treatment vs not having surgical correction prior to starting treatment. They found that those that had surgery were twice as likely to become pregnant.
Other studies have also looked at mechanisms for how polyps could interfere with implantation. Here the evidence is equally compelling. In addition to the mechanical interference; polyps have been linked to various chemical changes in the uterine environment—especially involving certain markers of implantation and inflammation.
At our center, we go through great lengths to create and identify the healthiest embryos possible to help our patients achieve the highest attainable live birth rate. Therefore we always take steps to make sure that we’re placing embryos into the best possible uterine environment. Timing is also important in considering when to remove polyps. At least one study found that 27% of polyps will go away on their own. So we don’t plan any such surgery until we know we have healthy embryos to transfer or our patient is ready to become pregnant.
Robert Greene, MD, FACOG
Conceptions Reproductive Associates