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Hum. Reprod. Advance Access published online on March 10, 2005
Human Reproduction, doi:10.1093/humrep/deh822
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received November 9, 2004
Revised January 17, 2005
Accepted January 27, 2005

Article

Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study

Tirso Pérez-Medina 1*, José Bajo Arenas 1, Francisco Salazar 1, Teresa Redondo 1, Luis Sanfrutos 1, Pilar Alvarez 1, and Virginia Engels 1

1 Department Of Gynaecology, Santa Cristina University Hospital, Universidad Autónoma de Madrid, C/O'Donnell 59, 28009 Madrid, Spain

* To whom correspondence should be addressed.
Tirso Pérez-Medina, E-mail: tperezm{at}meditex.es


  Abstract

BACKGROUND: It was our intention to determine whether hysteroscopic polypectomy before intrauterine insemination (IUI) achieved better pregnancy outcomes than no intervention. METHODS: A total of 215 infertile women from the infertility unit of a university tertiary hospital with ultrasonographically diagnosed endometrial polyps (EP) undergoing IUI were randomly allocated to one of two pretreatment groups using an opaque envelope technique with assignment determined by a random number table. Hysteroscopic polypectomy was performed in the study group. Diagnostic hysteroscopy and polyp biopsy was performed in the control group. RESULTS: Total pregnancy rates and time for success in both groups after four IUI cycles were compared by means of contingency tables and life-table analysis. A total of 93 pregnancies occurred, 64 in the study group and 29 in the control group. Women in the study group had a better possibility of becoming pregnant after polypectomy, with a relative risk of 2.1 (95% confidence interval 1.5-2.9). Pregnancies in the study group were obtained before the first IUI in 65% of cases. CONCLUSIONS: These data suggest that hysteroscopic polypectomy before IUI is an effective measure.

Keywords: endometrial polyps; hysteroscopic polypectomy; infertility; intrauterine insemination.
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