Hi skigirl,
It certainly appears that endometrial polyps (also called uterine
polyps) do interfere with the ability to conceive. I could find no
hard data referring to implantation impedance however, and in fact,
one of the sites I reference below
(http://eastcoastivf.com/Surgery.html#poly) states there is no data
available.
This Fertility World site however, gives us a hint that polyps can
interfere with implantaion. The presence of polyps ?? results in areas
of reduced blood flow and thinner, less glandular endometrium. These
areas may be suboptimal for implantation. Once identified, anatomic
endometrial abnormalities should be corrected, if possible. Often,
this- can be accomplished with outpatient surgical procedure performed
through the hysteroscope.?
http://www.fertilityworld.org/content/doc_755/en/version_1/doc.asp
Endometrial polyps are overgrowths of the uterine lining. ?The mere
presence of polypoid overgrowths in the uterine cavity may (at least
theoretically) interfere with implantation and fertility. I have
envisioned polyps as acting sort of like IUDs in the cavity, creating
a hostile environment for embryo implantation. I remove endometrial
polyps in women with reproductive problems and these women
(anecdotally) seem to do remarkably well in subsequent fertility
efforts. A well designed research project describing fertility outcome
after treatment for different types of endometrial polyps would be
valuable?
From the Labor of Love web site
http://www.thelaboroflove.com/forum/loss/circulation.html
I can certainly understand your desire to avoid surgery, and the
decision to have surgery is not to be taken lightly. But, it seems
that a hysteroscopy with polyp removal *would* improve your chances of
conceiving. Keep in mind that the hysteroscopy is an intravaginal
procedure. Depending on your what particular case dictates, you may
have no surgical scar at all to worry about. Your doctor is unable to
say for sure if and when you can conceive with a uterine polyp, which
is why she may appear to be nonchalant. Evidence shows that some women
do indeed become pregnant, and with no complications, while others
suffer miscarriages, and others never conceive at all. Having a
uterine polyp most certainly makes conceiving more difficult. Perhaps
you could give yourself a certain period of time, a self-imposed
deadline, to conceive before you consider surgery. While I can?t
recommend or counter surgery for you, if it were me or my daughter, I
would lean towards having the polyp removed, and then try to conceive.
From Gyn Alternatives: ?Like the standard hysteroscope, the
resectoscope is inserted through the cervix. It is larger in
diameter than the diagnostic hysteroscope and requires dilation of the
cervix. Procedures using the resectoscope are almost always done in
an operating room, such as in an outpatient surgery center. Minor
procedures can be done under local anesthesia, but most women prefer
general anesthesia. The resectoscope is far more efficient at
removing tissue (such as fibroids or large polyps) than conventional
instruments?
http://www.gynalternatives.com/resectos.htm
More on hysteroscopy, from the University of South Carolina School of
Medicine, Dept. of Obstetrics and Gynecology.
http://www.facs.org/public_info/operation/hysteroscopy.pdf
and
Advanced Fertility Center of Chicago
http://www.advancedfertility.com/hysteros.htm
This PubMed brief states that 80% of the women in their study
conceived after removal of endometrial polyps.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12731738&dopt=Abstract
??These blood vessels bleed, leading to spotting or vaginal bleeding.
If the polyp interferes with the egg and sperm, it may make it hard to
get pregnant. Nobody knows how common this is. It is also possible
that they may lead to a slightly higher chance of miscarriage, but
this is also unknown. Most gynecologists will remove polyps, as
discussed below, if they are found in women with a history of
miscarriage.
http://www.obgyn.net/displayarticle.asp?page=/women/articles/polyps_dah
According to The Recurrent Pregnancy Loss web site, ?Abnormalities
within the uterine cavity are found in 10% of women experiencing
pregnancy loss. Endometrial polyps are found in 36% of these women.?
You can see the chart on the link below, about halfway down the page.
The same site, on a different page says of surgical removal of polyps
?Successful pregnancy rates after removal of endometrial polyps have
be reported to be increased by 3-4 fold compared to before removal,
submucous fibroids and endometrial adhesions by 2-3 fold.? (Found
about halfway down the page)
http://haveababy.com/rpl/treatment.asp
and
http://haveababy.com/rpl/diagnosis.asp
?Therefore, if a polyp occupies a significant portion of the uterine
cavity, one could imply that it can adversely affect embryo
implantation. In the same study noted above, 24% of the infertile
population had documented endometrial polyps. Much like submucous
myomas, office hysteroscopy can easily detect even very small
endometrial polyps. Polyps or fibroids, lesions of glandular or muscle
tissue, which are found on the wall of the uterus. They disrupt the
uterine cavity and may result in repeated pregnancy losses or
heavy/irregular menstrual bleeding. The uterine cavity shape can
initially be evaluated by hysterosalpingogram (HSG) or
sonohysterogram. These radiologic and ultrasound procedures can image
the uterine cavity. They would be seen as a filling defect. Polyps and
fibroids can be removed by hysteroscopic resection.?
http://eastcoastivf.com/Surgery.html#poly
and
IVP Care
http://www.ivpcare.com/Infertility/inf_clin_per_hysteroscopy.asp
From the University of Virginia, a picture of an endometrial polyp.
**** This picture is rather graphic. If you are squeamish, you may
choose not to click on the link!
http://www.med-ed.virginia.edu/courses/path/gyn/uterine5.cfm
The Strong Health site says this about risks of hysteroscopy: ?The
possible risks of Hysteroscopy include bleeding, infection and uterine
perforation. Fortunately, these risks are infrequent. Occasionally,
your physician will utilize a simultaneous Laparoscopy to aid in the
prevention of uterine perforation if extensive Hysteroscopy surgery is
planned.?
http://www.stronghealth.com/services/womenshealth/ivf/currentpatients/infertilitysurgery/hysteroscopy.cfm
According to this site, risks of hysteroscopy surgery are minimal.
http://www.beachcenter.com/surgical/hysteroscopy.shtml
By the way, the word ?echogenic?, found in your report, means
?pertaining to a structure?, in this case, tissue, that has echoes
onside it. Echo is Greek for ?sound?, and ?genos? is the Greek word
for ?birth?. This simply means your polyp was ?seen? using sound
waves.
From Books.md?s dictionary:
Producing an acoustic shadow. Something that can be seen on an
ultrasound or echocardiogram. Often relates to a more prominent
feature of a normal structure
http://www.books.md/E/dic/echogenic.php
I hope this answers your question. If any part of my answer is
unclear, please request an Answer Clarification before rating, and I
will assist you further, if possible.
I wish you the best!
Regards, crabcakes-ga
Search terms
Endometrial polyps pregnancy
Uterine polyps pregnancy |
Clarification of Answer by
crabcakes-ga
on
21 Jan 2004 16:51 PST
This page on Southeastern Fertility has a good illustration of the procedure:
http://www.sefertility.com/services_laparoscopy.html
From the London Fertility Centre:
?Hysteroscopy and laparoscopy are commonly performed together thereby
giving maximum information about the state of the pelvis.
As a general anaesthetic is administered, you are advised to go home
with an escort and not to drive yourself. It is wise to take things
easy the day following your operation prior to resuming your normal
activities.
When you wake up after the operation, you may have slight discomfort
but the doctor will normally have put local anaesthetic into the small
incisions made during the laparoscopy. In addition, the sutures used
to close the incisions are usually hidden under the skin and do not
need removal?
http://www.lfc.org.uk/fertility_treatments/Laparoscopy_Hysteroscopy.htm
This Fact Sheet from OBGYN Net is an good source for you to read through.
http://www.obgyn.net/hysteroscopy/hysteroscopy.asp?page=/hysteroscopy/articles/LH_faqs
OBGYN net home page:
http://www.obgyn.net/hysteroscopy/hysteroscopy.asp
Laparoscopic information from IVF Infertility
http://www.ivf-infertility.com/infertility/investigations/female/laparoscopy.php
Another site from IVP, (Read it fast!) a description of laparoscopy
http://www.ivf.com/laprscpy.html
Also from IVP, an explanation of Micro-laparoscopy (There are some
graphic photos present) At the bottom of the page with a link to a
short video of the removal of adhesions. This link worked just now!)
http://www.ivf.com/microlap.html
A somewhat graphic illustration here (It?s covered with watermarks,
but you can get the idea)
http://www.doereport.com/generateexhibit.php?ID=8070
Infertility Tutorials has a short explanation of laparoscsopy, but
some detailed information on the following link on the incision and
its care:
http://www.infertilitytutorials.com/procedures_members/case_surgery_incisions.cfm
http://www.infertilitytutorials.com/procedures_members/surgery_incisions.cfm
Complications:
From the Geneva Foundation for Medical Foundation and Research, this
excellent source of information regarding the complications of
laparoscopy. Per this site, ?The incidence of laparoscopic
complications is 1.1% to 5.2% in minor procedures and 2.5% to 6% in
major ones?. (This material is written primarily for medical
personnel, and can be a bit intimidating, not to mention scary! Keep
that in mind!)
http://www.gfmer.ch/Books/Endoscopy_book/Ch23_Complications_Lap.html
Risks, while rare, do occur. Friends of Queensland Fertility Group
site states ?In around 2 in 1000 cases major surgery may be necessary
to repair injuries to the various abdominal organs which can occur
during insertion of the instruments through the abdominal wall. This
risk is increased in patients with a history of the following: pelvic
infections, abdominal surgery, severe endometriosis, obesity, or
excessive thinness. Other risks include bruising around the incision
sites and complications of anaesthesia. The risk of death during
laparoscopy is around two per 100,000 which is less than the risk of
death during a pregnancy.?
http://www.geocities.com/HotSprings/2952/lap.htm
http://www.laparoscopyhospital.com/hysteroscopy.htm#What%20are%20the%20complication%20of%20endoscopy
Laparoscopic Hospital has a very well set up site, with explanations
of all aspects of laparascopy:
http://www.laparoscopyhospital.com/complication.htm
I hope this has been helpful, and again, I wish you the best skigirl!
(If you are seeing small boxes in your answer, I apologize. They were
not there earlier, and I do not know the cause for them. If the boxes
make any part of the answer illegible, please ask for an Answer
Clarification, and I?ll see what I can do with the formatting.)
Sincerely,
crabcakes
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