Endometrial Polyps and Submucous Myomas as a Cause of Infertility. Analysis of Post-hysteroscopic Resection Results

Abstract

The aim of our study was to investigate the efficacy and reproductive outcome after bipolar hysteroscopic resection of intrauterine polyps and submucous myomas in patients with infertility. A randomized clinical trial was conducted in a total of 181 patients with a history of intrauterine pathology and concomitant infertility problems of which 134 patients were diagnosed with an endometrial polyp and 47 – with a submucous intrauterine fibroid structure. Modern endoscopic methods were used to determine the perioperative and operative behaviour, such as diagnostic hysteroscopy with a 6-mm hysteroscope, as well as a hysteroscopic resection with a 9-mm hysteroscope. Successful pregnancy rate in the postoperative period was 62.4% as compared to the complete absence of successful pregnancies in the preoperative period. In the group of women with previously diagnosed submucous myomas, 74.4% of women conceived in the postoperative period as a result of the hysteroscopic procedure. As far as patients with a previously diagnosed endometrial polyp were concerned, successful pregnancies were accomplished in 60.4% of women. Based on the results of the present study, it can be concluded that the elimination of existing intrauterine pathology, especially the one which leads to changes in the contour of the uterine cavity, significantly increases the chances of pregnancy in patients with previous infertility.