Uterine Polyps, Fibroids, and Their Role in IVF Treatment

Polyps are abnormal tissue growths, usually soft in structure, that can appear in various parts of the body. While they can be found in areas like the ear canal, nose, or stomach in medical literature, the most critical ones for women's health are endometrial (uterine) polyps.

As HRS Ankara, in this article, we discuss the causes of uterine polyps, their differences from fibroids, and their importance for our patients considering In Vitro Fertilization (IVF) treatment.

What Are Uterine (Endometrial) Polyps?

Uterine polyps form as a result of excessive cell growth in the “endometrium” layer that lines the inner wall of the uterus. Their size can range from a sesame seed to a golf ball. There may be a single one or multiple polyps. Although they are mostly benign structures, they may require pathological examination and follow-up.

Causes and Risk Factors of Polyp Formation

While the exact cause of polyp formation is not fully determined, it is thought that hormonal balances (especially estrogen fluctuations) are effective in this process. Risk factors include:

• Age Factor: The frequency of occurrence may increase in the pre- and post-menopausal periods (40-50 age range).
• Hormonal Medications: They may develop as a side effect of some drugs used in conditions such as breast cancer treatment.
• Obesity and Hypertension: Metabolic factors can pave the way for polyp formation.

How Are Uterine Polyps Diagnosed?

Based on your symptoms, your specialist physician will perform a detailed pelvic examination. Modern imaging methods are used to clarify the diagnosis:

• ✔ Transvaginal Ultrasound: Allows visualization of the inside of the uterus with high-frequency sound waves.
• ✔ SIS (Saline Infusion Sonography): Sterile fluid is injected into the uterus to expand the walls and allow for a clearer view of the polyps.
• ✔ Hysteroscopy: It is the gold standard in diagnosis and treatment. A thin device with a camera at the tip is inserted into the uterus to both diagnose and, if necessary, remove the polyp in the same session.

What Is the Difference Between Fibroids and Polyps?

These two structures, which are often confused, actually originate from different tissues. Polyps originate from the inner lining of the uterus (endometrium), while fibroids are usually benign muscle knots originating from the uterine muscle layer (myometrium).

Both conditions can show similar symptoms such as irregular bleeding and difficulty in conceiving. The treatment approach is determined individually based on the size, location of the mass, and the patient's pregnancy plan.

Management of Polyps and Fibroids in IVF Treatment

The goal in In Vitro Fertilization (IVF) treatment is to ensure that a healthy embryo successfully attaches to the uterine lining (endometrium). Polyps occupying space in the uterine cavity or fibroids pressing on the uterine lining can mechanically prevent the embryo from implanting.

Is Hysteroscopy Necessary Before Treatment?
If a suspicious structure, polyp, or fibroid is detected in the uterus during ultrasound checks, it may be recommended to remove these structures via Hysteroscopy before the IVF transfer. Studies in the literature show that correcting intrauterine pathologies can positively contribute to pregnancy rates.

IVF treatment can be considered in the following cases:

• Unexplained infertility,
• Blocked or damaged tubes,
• Low sperm parameters,
• Advanced stage endometriosis,
• Ovulation disorders.

When Should You See a Doctor?

If you are experiencing post-menopausal bleeding, severe abdominal pain, or extreme irregularities in your menstrual cycles, it is important to consult a gynecologist without delay. Early diagnosis increases the success of treatment options.