Can polyps in the womb stop me getting pregnant?

What are polyps?

Polyps are small growths, which can arise, in different organs like bowels, nose, uterus, cervix and rarely in vagina. They are mostly benign (i.e., not cancer).

They are quite common. 1 in 10 women in the general population will have polyp.

Polyps are common and mostly benign

What are the symptoms?

Majority of the polyps do not cause any symptom and are seen only during routine ultrasound scan. Sometimes uterine polyps can cause bleeding in between periods, which is seen more commonly in women closer to menopause.

Most polyps do not cause any symptoms

Can polyps stop me from getting pregnant?

This is quite controversial. Many women with polyp do conceive naturally and have successful pregnancies. Women who are struggling to conceive undergo ultrasound scan as part of their investigation and has an increased diagnosis of asymptomatic polyps.

There are various ways polyps can affect your chances of getting pregnant or cause miscarriage.

1. Location: If the polyp is located near the opening of the tube, it can cause tubal blockage and can cause difficulty in conceiving.

Whereas, a small polyp located near the lower end of the uterus or in the cervix or vagina are unlikely of any significance.

2. Effect on the lining of the uterus: It can produce various chemicals that can interfere with implantation of the embryo.

Most women with polyps will conceive naturally. It is controversial whether polyps cause infertility.

How can I know if I have polyp in the uterus?

The diagnosis of polyp is mainly by ultrasound scan. Saline infusion sonography + 3D scan and hysteroscopy are highly accurate in diagnosing uterine polyps. Hysteroscopy has the advantage of diagnosing and treating polyps at the same sitting.

Most polyps are diagnosed by ultrasonography.

Do I need to get the polyp removed?

A small polyp of the size less than 1-2 cm usually does not need immediate surgery if this is not causing any symptom.

1 in 4 polyps will disappear on their own as they might be shed along with the bleeding during periods.

Surgery is needed for larger polyps, or for those associated with abnormal bleeding or in older women who are pre-menopausal.

Polyps should be removed if diagnosed after menopause.

Studies have shown that removal of polyps improves chances of natural conception in women with otherwise unexplained infertility and also that of IUI and IVF, especially those >1.5-2 cm.

Most clinicians will suggest removal of polyp if diagnosed before starting IVF. If diagnosed while having IVF, then the embryos can be frozen and transferred later after removing the polyp.

Most polyps disappear spontaneously and do not require surgical removal. Polyp removal might be advised if you are having symptoms, having unexplained infertility or undergoing IUI or IVF.

What are the risks of surgery for polyps?

Polyps can be removed through hysteroscopic surgery with or without general anaesthetics. It is a day case procedure and most patients will go home on the same day after the surgery.

Complications are rare; depends largely on incorrect procedure or instrument. There are risks of

· infection,

· bleeding,

· injury to the cervix,

· uterine perforation,

· recurrence of polyp,

· scarring of the endometrium (lining of the uterus) and

· complications due to excessive absorption of fluid or gas used to distend the uterus.

Bottom line:

Uterine polyps are common, benign growths in the endometrium (uterine lining), which mostly disappear spontaneously and do not need surgery.

Most women with uterine polyps conceive naturally.

Polyp removal might be helpful if you have abnormal bleeding, unexplained infertility or undergoing IUI or IVF.

Written by: Dr Anupa Nandi