Uterine polyps are common growths that develop on the inner lining of the uterus, known as the endometrium. These growths, an overgrowth of endometrial tissue, are also called endometrial polyps. They can vary significantly in size, ranging from a few millimeters to several centimeters. While usually non-cancerous, polyps attach to the uterine wall by either a broad base or a thin stalk and can sometimes extend into the vaginal canal. A common concern for many individuals is how these polyps might affect their ability to conceive and maintain a pregnancy.
Uterine Polyps and Fertility
It is possible to become pregnant with uterine polyps, but they can interfere with fertility. Polyps may pose challenges to conception through several mechanisms. For instance, they can physically obstruct the movement of sperm, preventing them from reaching an egg.
Beyond physical obstruction, uterine polyps can also hinder the implantation of an embryo. A polyp’s irregular surface can make it difficult for a fertilized egg to attach properly to the uterine wall. Additionally, the presence of polyps can create a localized inflammatory response within the uterus, which can make the uterine environment less receptive to implantation.
Studies indicate polyps can be a factor in infertility. One study found that the chance of pregnancy was lower in individuals with untreated polyps compared to those who had them removed. The location of the polyp within the uterus might also play a role, with polyps near the fallopian tubes potentially causing more difficulty in conceiving.
Navigating Pregnancy with Polyps
If pregnancy occurs with uterine polyps, there are potential considerations. One common concern is an increased risk of bleeding or spotting. This bleeding can occur due to the polyp’s fragile blood vessels, which may rupture more easily during pregnancy.
Research suggests a potential association between uterine polyps and an increased risk of miscarriage. Polyps can disrupt placental development and may affect blood supply to the developing embryo, contributing to early pregnancy loss. The inflammatory environment created by polyps might also make the uterus less hospitable for a developing pregnancy.
While these concerns exist, many pregnancies with polyps proceed without complications. The impact of polyps on pregnancy can depend on their size, number, and location. Individuals with polyps who become pregnant are often monitored closely by their healthcare providers to assess any potential risks.
Treatment and Management Options
Uterine polyps are typically diagnosed using imaging techniques. A transvaginal ultrasound is often the initial step to identify polyps. For a clearer view, hysterosonography (saline infusion during ultrasound) or hysteroscopy (inserting a thin, lighted telescope) may be performed. An endometrial biopsy can also collect tissue for examination, confirming diagnosis and checking for abnormal cells.
Management of uterine polyps varies based on symptoms and reproductive goals. Small polyps that do not cause symptoms may be observed without immediate intervention, as some can resolve on their own. However, if polyps are causing symptoms like abnormal bleeding or are suspected to interfere with fertility, removal is often recommended.
The primary method for removing uterine polyps is a hysteroscopic polypectomy. This minimally invasive procedure involves inserting a hysteroscope through the vagina and cervix to visualize and remove the polyp. Polyp removal is frequently performed to improve fertility outcomes, alleviate symptoms, or analyze tissue for malignancy. If polyps are discovered during an ongoing pregnancy, they are typically observed unless severe bleeding or complications arise, as surgical removal during pregnancy carries additional considerations.