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Endometrial Polyps

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Ultrasound Imaging in Reproductive Medicine

Abstract

A thorough review of the literature regarding the modalities employed for diagnosis of endometrial polyps and their impact on infertility is presented.

Endometrial polyps are responsible for approximately one-fourth of cases of abnormal genital bleeding in both premenopausal and postmenopausal women. They can be hyperplastic, atrophic, or functional and are rarely associated with malignancy.

As recommended by the 2012 AAGL guidelines, transvaginal ultrasound is the initial imaging of choice, with MRI reserved for indeterminate cases or where sampling is difficult.

The frequency of unrecognized intrauterine pathologies in patients with recurrent implantation failure can vary from as low as 18 % to as high as 50 %. Even though endometrial polyps are the most common pathology found in these patients, it is controversial whether they contribute to infertility or poor pregnancy outcomes. However, it is plausible that polyps can cause infertility due to mechanical interference with sperm and embryo transport, impairment of embryo implantation, or altered endometrial receptivity. Furthermore, the size, number, or location of polyps may influence any effect on reproductive outcomes.

Hysteroscopic removal of endometrial polyps appears to improve spontaneous pregnancy rates in women with otherwise unexplained infertility. For patients with infertility and polyps, removal of disease is likely to be helpful to subsequent pregnancy.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, 601 Colley Ave, Norfolk, VA, 23507, USA

    Silvina M. Bocca MD, PhD

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Correspondence to Silvina M. Bocca MD, PhD .

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  1. Department of Obstetrics and Gynecology, Eastern Virginia Medical School Jones Institute for Reproductive Medicine, Norfolk, Virginia, USA

    Laurel Stadtmauer

  2. Institute for Human Reproduction, Chicago, Illinois, USA

    Ilan Tur-Kaspa

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Bocca, S.M. (2014). Endometrial Polyps. In: Stadtmauer, L., Tur-Kaspa, I. (eds) Ultrasound Imaging in Reproductive Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9182-8_11

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