Uterine polyps often raise questions about fertility and pregnancy. These common growths impact conception and gestation, making it important for those trying to conceive to understand their effects.
Understanding Uterine Polyps
Uterine polyps, also known as endometrial polyps, are non-cancerous growths that develop from the endometrium, the tissue lining the inside of the uterus. They form when cells in this lining overgrow, creating a projection that attaches to the uterine wall with either a broad base or a thin stalk. While typically benign, some polyps can be precancerous or, rarely, cancerous.
Polyps vary in size from a few millimeters to several centimeters. Individuals might have a single polyp or multiple polyps present in the uterus. Common symptoms associated with uterine polyps include irregular bleeding between menstrual periods, unusually heavy menstrual flow, or vaginal bleeding after menopause. Some individuals experience no symptoms.
Impact on Conception
Uterine polyps can interfere with conception. Their physical presence can obstruct the pathway for sperm to reach an egg. For instance, a polyp located near the fallopian tubes or in the cervical canal might hinder sperm transport, making fertilization more difficult.
Beyond physical blockage, polyps can also disrupt the implantation process of an embryo. By occupying space within the uterine cavity, they may prevent a fertilized egg from properly attaching to the uterine wall. Some evidence suggests that polyps can induce a chronic inflammatory response within the uterus, creating an environment that is unfavorable for embryo implantation. Despite these potential interferences, it is still possible for some individuals with uterine polyps to become pregnant.
Pregnancy with Uterine Polyps
If pregnancy occurs with uterine polyps, there are potential considerations and risks. There may be an increased risk of bleeding, particularly during the early stages of pregnancy. While not definitively strong for all polyps, there is also a potential association between uterine polyps and an increased risk of miscarriage.
Rarely, polyps may be linked to other complications later in pregnancy, such as preterm labor or issues with the placenta. Polyps can also change in size during pregnancy, either growing or shrinking, likely due to fluctuating hormonal levels. Many pregnancies with small or asymptomatic polyps, however, proceed without complications.
Management and Fertility
The diagnosis of uterine polyps often involves imaging techniques and direct visualization. A transvaginal ultrasound is a common non-invasive method that can help identify the presence and size of polyps. For a more detailed view and confirmation, a hysteroscopy is often performed, which involves inserting a thin, lighted tube with a camera through the vagina and cervix into the uterus, allowing for direct examination of the uterine lining.
For individuals trying to conceive, hysteroscopic polypectomy, the surgical removal of the polyp, is frequently recommended. This procedure is particularly advised if the polyps are causing symptoms or are of a larger size. Removing uterine polyps can significantly improve the chances of conception.
Studies have shown an increase in pregnancy rates after polypectomy, with some research indicating that removal can more than double the chance of pregnancy compared to not removing them. This improvement is thought to occur by clearing the uterine cavity for implantation and reducing any inflammatory responses caused by the polyps. However, not all polyps require removal, especially if they are small, asymptomatic, and fertility is not an immediate concern.