Hysteroscopic polypectomy versus expectant management in endometrial polyps in asymptomatic infertile women: a meta-analysis

Authors

  • Tauane Bahia Modesto Department of Life Science, Bahia State University, Salvador - Bahia - Brazil
  • Amanda Tamiris Barbosa Dias Department of Life Science, Bahia State University, Salvador - Bahia - Brazil
  • Sofia Andrade de Oliveira Department of Life Science, Bahia State University, Salvador - Bahia - Brazil

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202770

Keywords:

Endometrial polyps, In-vitro fertilization, Intrauterine insemination, Marital infertility, Ovulation induction, Ovarian stimulation, Polyp, Sub fertile

Abstract

Background: Endometrial polyp is a hyperplastic structural abnormality of the uterine cavity and is one of the most commonly found intrauterine abnormalities. The endometrial polyp is mostly asymptomatic and sometimes diagnosed only during infertility investigation. The influence of endometrial polyps on female infertility is not completely understood, however, due to the possibility of endometrial polyps influencing fertility, their removal is usually performed in women undergoing infertility treatment.

Methods: This meta-analysis was performed through an electronic search using MEDLINE, PubMed in October 2017, bringing together the terms of interest in order to select studies that would compare polypectomy and expectant management for endometrial polyps in sub fertile women. Four articles were selected according to the inclusion and non-inclusion criteria.

Results: Five variables were collected from the selected articles to be compiled and analyzed (rate of live births per transferred embryo, chemical pregnancy rate, spontaneous abortion rate, implantation rate and clinical pregnancy rate), none of which showed any difference statistically significant in conduct.

Conclusions: The data concluded that there is no statistical significance between expectant management and polypectomy.

References

Doldi N, Persico P, Di Sebastiano F, Marsiglio E, De Santis L, Rabellotti E, et al. Pathologic findings in hysteroscopy before in vitro fertilization-embryo transfer (IVF-ET). Gynecol Endocrinol. 2005;21(4):235-7.

Rackow BW, Jorgensen E, Taylor HS. Endometrial polyps affect uterine receptivity. Fertil Steril. Elsevier Ltd; 2011;95(8):2690-2.

Ghaffari F, Arabipoor A, Bagheri N, Hosseini F. Hysteroscopic polypectomy without cycle cancellation in IVF/ICSI cycles: a cross-sectional study. Eur J Obstet Gynecol Reprod Biol. Elsevier Ireland Ltd; 2016;205:37-42.

Pérez-Medina T, Bajo-Arenas J, Salazar F, Redondo T, Sanfrutos L, Alvarez P, et al. Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. Hum Reprod. 2005;20(6):1632-5.

Lass A, Williams G, Abusheikha N, Brinsden P. The effect of endometrial polyps on outcomes of in vitro fertilization (IVF) cycles. J Assist Reprod Genet. 1999;16(8):410-5.

Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The international committee for monitoring assisted reproductive technology (ICMART) and the world health organization (WHO) revised glossary on ART terminology, 2009. Human Reprod. 2009;24(11):2683-7.

Kamel RM. Management of the infertile couple: an evidence- based protocol. 2010 [cited 2017 Nov 19]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844387/pdf/1477-7827-8-21.pdf

Di Spiezio Sardo A, Di Carlo C, Minozzi S, Spinelli M, Pistotti V, Alviggi C, et al. Efficacy of hysteroscopy in improving reproductive outcomes of infertile couples: a systematic review and meta-analysis. Hum Reprod Update. 2016;22(4):479-96.

Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BW, illem J, et al. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane database Syst Rev. 2015;2(2):CD009461.

Varasteh NN, Neuwirth RS, Levin B, Keltz MD. Pregnancy rates after hysteroscopic polypectomy and myomectomy in infertile women. Obstet Gynecol. 1999;94(2):168-71.

Cholkeri-Singh A, Sasaki KJ. Hysteroscopy for infertile women: a review. J Minim Invasive Gynecol. 2015;22(3):353-62.

Jayaprakasan K, Polanski L, Sahu B, Thornton JG, Raine-Fenning N. Surgical intervention versus expectant management for endometrial polyps in subfertile women. Cochrane Database Syst Rev. 2014;(8):CD009592.

Silva ACJS, Silva JC, Reis FJC, Nogueira AA, Ferriani RA. Routine office hysteroscopy in the investigation of infertile couples prior to assisted reproduction. Int Congr Ser. 2004;1271(C):255-8.

Golan A, Eilat E, Ron-el R, Herman A, Soffer Y, Bukovsky I. Hysteroscopy is superior to hysterosalpingography in infertility investigation. Acta Obstet Gynecol Scand. 1996;75(7):654-6.

Bakas P, Hassiakos D, Grigoriadis C, Vlahos N, Liapis A, Gregoriou O. Role of hysteroscopy prior to assisted reproduction techniques. J Minim Invasive Gynecol. 2014;21(2):233-7.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41.

Batioglu S, Kaymak O. Does hysteroscopic polypectomy without cycle cancellation affect IVF?. Reprod Biomed Online. 2005;10(6):767-9.

Downloads

Published

2020-06-25

Issue

Section

Meta-Analysis