Location of endometrial polyp and pregnancy rate in infertility patients.

Objective: To assess endometrial polyp location and abnormal endometrial findings and their impact on pregnancy rate.

Design: Retrospective study.

Setting: Reproductive clinic in Kanagawa, Japan.

Patient(s): A retrospective study was conducted on 230 infertility patients who had an endometrial polyp, as suspected on the basis of ultrasound and as diagnosed by hysteroscopy.

Intervention(s): Polyps were excised by either polypectomy or curettage. All samples were examined for pathology. The endometrial cavity was subdivided into five area categories: uterotubal junction, anterior uterine wall, posterior uterine wall, lateral uterine wall, and multiple. The patients received < or =6 months of follow-up; pregnancy rates were compared between the five subdivisions.

Main Outcome Measure(s): Pregnancy rates.

Result(s): The incidence of endometrial polyps was as follows, by location: uterotubal junction, 8.0%; posterior uterine wall, 32.0%; anterior uterine wall, 15.4%; lateral uterine wall, 9.2%; and multiple, 35.4%. The pregnancy rate after surgery was as follows, by location: uterotubal junction, 57.4%; posterior uterine wall, 28.5%; anterior uterine wall, 14.8%; lateral uterine wall, 18.8%; and multiple, 40.3%. Endometrial hyperplasia was found in 6.9% of the cases. The pregnancy rate after surgery at the uterotubal junction was significantly higher than that of other locations.

Conclusion(s): Endometrial polyps are commonly found on the posterior wall of the uterus; however, excision of polyps that were located at the uterotubal junction significantly improved the pregnancy rate. Endometrial polyps should be categorized by both size and location.