Before starting an assisted reproduction treatment, it is normal to undergo a detailed study of the uterus. In these check ups, there can be some findings such as polyps or fibroids. Although both are benign conditions, they can raise many questions for women undergoing fertility treatment.
What are polyps and fibroids?
- Endometrial polyps: there are some growths, like warts, on the inner lining of the uterus (endometrium). In many cases they do not produce symptoms, although sometimes they can be associated with irregular bleedings. They are usually only a few millimeters in size.
- Uterine fibroids: they are benign tumors formed from the muscular tissue of the uterus (myometrium). They can vary in size and location.
Can they affect fertility?
The impact depends mainly on their location. If a polyp or fibroid protrudes into the uterine cavity, it can interfere with embryo implantation or increase the risk of miscarriage.
However, in contrast, when fibroids are located outside the uterine cavity (intramural or subserosal) and do not distort it, they usually have less impact on assisted reproduction treatments.
How are they diagnosed?
Diagnosis is done mainly through:
- Transvaginal scans, which allows visualization of size and location.
- Hysteroscopy, a technique which involves introducing a small camera into the uterus and offering a direct look at the endometrium.
What is the most common approach?
Endometrial polyps are usually removed through surgical hysteroscopy, a minimally invasive procedure.
In the case of fibroids, the decision depends on their size, symptoms, and effect on the uterine cavity. Those that affect the endometrium are generally recommended to be removed before starting treatment.
Importance of pre-treatment evaluation
Identifying and treating polyps or fibroids helps optimize the chances of success in assisted reproduction treatments. That is why these initial evaluations are an essential part of the preparation before starting techniques such as IVF-ICSI or Artificial Insemination.