One of the causes of Infertility is an Endometrial or uterine polyp. It can also increase the risk of miscarriage. Endometrial polyp is a mass in the inner lining of the Uterus. They range in size from few mm to several cm.
- No definitive cause is known.
- Some are affected by Hormonal Treatment or changing of the normal hormones during the cycle (Estrogen and progesterone).
- It can be asymptomatic.
- Irregular menstrual bleeding.
- Post coital bleeding.
- Heavy period (menorrhagia)
- Bleeding after menopause.
- Some times dysmenorrhea (pain with menstrual periods)
Diagnosis can be done by ultrasound (vaginal) scan and Hysteroscopy. It can also be seen as a filling defect in a HSG (Hysterosalpingogram).
The best way to remove the polyp is by Hysteroscopy and Polypectomy. Some doctors do D & C but it can be missed. After removing the polyp it should be sent for Histopathology study as it can be Benign or malignant, although majority tend to be benign.
- Age → Commonly seen in females (between the age of 40 – 50)
- High blood pressure.
- Cervical polyps (when the female has a history of cervical polyp).
- Taking hormonal replacement therapy.
Sometimes, a fibroid can grow inside the uterine cavity (fibroid is a masses of tissue rooted and growing from the uterine muscle and then grow into the cavity). Such fibroids are referred to as sub-muscular-intra-cavitory fibroids.
These fibroids cause pelvic pain, heavy bleeding, and prolonged periods. The best way to treat this type of fibroid is by giving injections of Gonadotrophine antagonist for 1-2 months to reduce the size of fibroid followed by Hysteroscopy and Polypectomy. Some large size fibroids cannot be removed by Hysteroscopy and many require laparoscopic Myomectomy.