Uterine polyps

Uterine polyps are benign tumors that grow in the endometrium or inner lining of the uterus. Between 1 and 3 percent of women have uterine polyps; which are more common in women over 40.

Uterine polyps are oval shaped and can be microscopic or slowly grow to reach 5 centimeters in diameter. These are attached to the endometrium through a stem and can be single or multiple.

Although they usually appear in the uterine cavity, some polyps are also found in the cervix, fallopian tubes or vagina.

While some polyps are very small and do not affect fertility, others may interfere with sperm transport or the embryo implantation process.

Main uterine polyps symptoms

Although uterine polyps are often asymptomatic, they can sometimes manifest through:

  • Menorrhagia or abundant menstrual periods
  • Bleeding unrelated to menstrual periods
  • Bleeding after sexual intercourse
  • Anemia caused by frequent bleeding
  • Infertility
  • Recurrent miscarriage

It is believed that 25 percent of irregular bleeding is related to the presence of endometrial polyps.

It is also important to point out that the severity of the symptoms depends on the size, location and number of polyps.

Causes of uterine polyps

Although the specific cause of uterine polyps is unknown, growth is associated with ovarian hormonal activity, particularly with estrogen production.

There are also a number of known factors which may increase the risk of developing uterine polyps:

  • Anovulation
  • Arterial hypertension
  • Obesity
  • Being over 40 years of age
  • Use of Tamoxifen, a drug used in breast cancer treatments

How are uterine polyps diagnosed?

In addition to a physical examination and analysis of the medical history of the patient, diagnostic procedures for uterine polyps may include:

  • A transvaginal (or pelvic vaginal) ultrasound, in which the specialist carefully introduces an ultrasound probe into the patient’s vagina to examine her reproductive organs (uterus and ovaries). The transvaginal ultrasound is simple, painless and generally facilitates a clear diagnosis; however, additional tests may be required in some cases.
  • Sonohysterography, which consists of distending the uterine cavity using a liquid to facilitate endometrial evaluation.
  • Hysteroscopy, which consists in the introduction of a microscopic camera through the vagina and cervix to visualize any possible abnormalities in the uterine cavity. Hysteroscopy is an ambulatory surgical procedure, and if polyps are found it is easy to remove them during the same procedure, as polyps larger than 15 millimeters affect pregnancy probabilities.

Treatments to achieve pregnancy when you have uterine polyps

In-Vitro Fertilization (IVF) is a particularly effective treatment to achieve pregnancy. While uterine polyps usually alter sperm transport and embryo implantation, IVF allows our specialists to obtain the eggs directly from the patient’s ovaries. These eggs are fertilized under controlled laboratory conditions to generate embryos with a higher implantation potential which are then transferred back into the patient’s uterus.

Generally, uterine polyps do not affect the results of in vitro fertilization and the normal development of pregnancy; however, in some cases women must previously undergo a minor surgery known as hysteroscopy to remove the uterine polyps before continuing with an In-Vitro Fertilization (IVF) treatment. Hysteroscopy is an ambulatory process performed under anesthesia that consists on the introduction of a small optical system (provided with micro-surgical instruments) through the patient’s cervix.

Hysteroscopy is also necessary if your symptoms or medical history indicate you may be at risk of developing endometrial cancer. Although less than 1 percent of uterine polyps are associated with cancer, it is advisable that once they have been removed they are sent to the laboratory to confirm they are benign.