Endometrial polyps are benign, localized overgrowths of endometrial glands and stroma covered by endometrial epithelium.
Several authors agree that polyps may interfere with fertility, both by natural conception and intrauterine insemination.There are only few reports assessing the effect of endometrial polyps on IVF/ICSI cycles. In a study by Isikoglu et al, endometrial polyps <1,5cm discovered both before or during IVF/ICSI cycles did not seen to affect implantation and pregnancy rates. Lass et al, claimed that polyps <2cm did notdecrease pregnancy rates but increased miscarried rates. In this chapter we are going to analyses the factors that can influence the presence of endometrial polyps and the fertility of the women. Also studies have shown a higher frequency of endometrial polyps in patients with endometriosis compared those without the disease. Shen et al found endometrial polyps in 68,35% of the patients with endometriosis, compared with 20,51% in the control group.
The polyps are often asymptomatic but they can sometimes cause menstrual irregularities such as intermenstrual bleeding. They are commonly identified during the investigation for abnormal uterine bleeding and infertility. Little is know about the association between endometrial polyps and fertility. The mechanism by which polyps may adversely affect fertility is also poorly understood but may be related to mechanical
interference with sperm transport, embryo implantation, or through increased production of inhibitory factors such as glycodelin. Among other possible mechanism, the most empathized is an inflammatory process caused by the polyp acting in a similar way as an intrauterine device. Anatomical distortion of the endometrial cavity is another postulation and focuses mainly in the diminished volume of the endometrial cavity.
There area lot of postulations about a single or multiple mechanisms by why the polyps affect the endometrial receptivity.
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