Spontaneous pregnancy rate after hysteroscopic removal of endometrial polyps in infertility patients : experience at King Hussein medical center

Abstract EN

Objective: To evaluate the effectiveness of hysteroscopic trans-cervical resection of endometrial polyps in improving pregnancy rates.

Methods: This retrospective study at King Hussein Medical Center from March 2006 to January 2012.

One hundred and 25 patients were included with a diagnosis of primary or secondary infertility for a minimum of 2 years.

Endometrial polyps were diagnosed by trans-vaginal Ultrasound scan and confirmed later by hysteroscopy.

The inclusion criteria were age under 38 years, menstrual irregularities for at least 6 months, no other cause of infertility was found after diagnostic workup of the couples, minimum 2 years of infertility and 18 months of follow-up with attempts to conceive after hysteroscopic polypectomy.

All polyps were larger than 1.5 cm.

The effect of the different sizes of the polyps was not evaluated in our study.

Results: All 125 Patients had endometrial polyps on transvaginal scans and confirmed at hysteroscopic removal and histological examination.

Among patients of the study group, there were no significant differences in age, type or length of infertility, or follow-up period after the procedure.

The mean size of the endometrial polyps was 3.0 cm ± 0.5cm.

Sixty patients had endometrial polyp ≤ 2.8 cm and 65 patients had bigger or multiple endometrial polyps.

Following the procedure, menstrual irregularity was back to normal in 90% of patients.

After the procedure, the spontaneous pregnancy rate was 80% (100 patients of the total number of patients) and delivery at term rate was 70% (70 patients out of the 100 patients who conceived).

Spontaneous abortion rate in the first trimester of pregnancy was 12% (12 patients) of the total number of pregnant patients.

Type of infertility did not affect fertility rates after hysteroscopic polypectomy.

There were no complications related to the procedure in the study patients and only 13 patients (10.5%) had recurrence of their menstrual irregularities.

Conclusion: Fertility rate in patients with endometrial polyps and menstrual irregularities with no other cause to explain their infertility is significantly improved with trans-cervical polypectomy.

The procedure is also safe with low recurrence rate.