To determine if the incidence of small endometrial polyps detected hysteroscopically in an infertile population differed from that in an apparently fertile population as well as to assess whether removal of such lesions would enhance reproductive outcome. In a retrospective study, 166 permanently infertile women had undergone complete fertility evaluation. None of the women had experienced any change in their menstrual cycle. All patients were examined by combined laparoscopy and hysteroscopy simultaneously, as part of their routine infertility evaluation. In all patients laparoscopy did not reveal any pathology and the only pathologic finding during hysteroscopy was endometrial polyps. They were divided into two groups: 136 infertile patients (group 1) and 30 requesting a reversal of a previous tubal sterilization (group 2). When endometrial polyps were noted, they were removed by hysteroscopy and then examined histopathologically. The fertility-related factors, in women whose only apparent finding was endometrial polyps before and after hysteroscopy, were comparable. Patients were followed up to determine their reproductive outcome subsequent to removal of the polyps. 127 uterine cavities were successfully visualized in group 1 and 29 in group 2. Endometrial polyps were noted in 45 patients of group 1 (40%) and in 3 patients of group 2 (10%)(P < 0.01). Most polyps were located in the region of the utero-tubal junction and proved to be functional. A 50% pregnancy rate was achieved in the first semester after hysteroscopic polypectomy.
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