Persistent endometrial polyps may affect the pregnancy rate in patients undergoing intrauterine insemination

ObjectiveTo determine whether polypectomy before intrauterine insemination achieved better pregnancy outcomes than no intervention.Study design and settingA prospective comparative study conducted in a private assisted reproduction centre.Subjects and methodsA total of 120 women having asymptomatic endometrial polyp (EP) that was diagnosed by 3D ultrasound and color Doppler and undergoing IUI were randomly allocated to one of two pre-treatment groups. Hysteroscopic polypectomy was performed in the study group while in the control group no intervention was done. All patients were scheduled to receive four cycles of IUI in both groups within 12 months duration. The first IUI cycle was planned after three menstrual cycles in both groups.ResultsNo complications after hysteroscopic polypectomy were recorded. A total of 37 pregnancies occurred, 25 cases in the study group which included 57 cases and 12 cases in the control group which included 53 cases. Two cases in the study group and one case in the control group got pregnant during the 3 months waiting period, before performing IUI. Cumulative pregnancy rate in both groups after four IUI cycles was 23 (38.3%) in the study group and 11 (18.3%) in the control group. This difference was statistically significant (p = 0.015).ConclusionPersistent endometrial polyps are likely to impair reproductive performance in this selected patient group and hysteroscopic polypectomy before IUI can be considered an effective measure especially as it is a safe procedure with a low complication rate.