Abstract
The aim of this systematic review is to evaluate the evidence for the impact of polypectomy
on fecundity, implantation and live birth rates in women who are trying to conceive
spontaneously or by assisted conception. A literature search was performed to identify
all controlled studies that compared the effects of polypectomy or conservative management
of the polyp on pregnancy outcome. Among the three studies that met the inclusion
criteria, only one was a randomized controlled trial, which reported a significantly
higher pregnancy rates after polypectomy in women undergoing intrauterine insemination.
The other two studies were retrospective and suggested no beneficial effects of polypectomy
on women undergoing assisted conception. Meta-analytic pool was not feasible as the
studies varied in their design and the characteristics. While there is some evidence
from basic science studies to suggest a detrimental effect of polyps on fertility,
the evidence from clinical studies is scarce and conflicting. Polyps diagnosed prior
to commencement of controlled ovarian hyperstimulation (COH) for in vitro fertilization
(IVF) should therefore be removed. The management of polyps seen during the course
of COH for IVF should be individualized given the number of embryos created, the previous
reproductive history of the patient and the individual clinics’ success rates for
their frozen embryo programme.
Keywords
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Article info
Publication history
Published online: April 20, 2010
Accepted:
April 1,
2010
Received in revised form:
February 23,
2010
Received:
November 13,
2009
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
