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Minerva Obstetrics and Gynecology 2021 Apr 20

DOI: 10.23736/S2724-606X.21.04739-0


language: English

Fertility outcomes after hysteroscopic removal of intrauterine leiomyomas and polyps

Maria Chiara DE ANGELIS 1 , Attilio DI SPIEZIO SARDO 1, Jose CARUGNO 2, Alfonso MANZI 3, Felice SORRENTINO 4, Luigi NAPPI 4

1 Department of Public Health, Federico II University, Naples, Italy; 2 Obstetrics, Gynecology and Reproductive Sciences Department, University of Miami, Miami, FL, USA; 3 Department of Neurologic, Reproductive, and Odontostomatologic Sciences, Federico II University, Naples, Italy; 4 Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy


INTRODUCTION: Thanks to the progress of science, it is now understood that a successful implantation not only depends on the quality of the embryo, but also on having a receptive endometrium. During the years, several authors have reviewed the important role of the uterine factor, ranging from the congenital anomalies, such as uterine septa and subsepta, and acquired conditions such as endometrial polyps and submucous myomas. Currently, hysteroscopy has proved to be a powerful and accurate tool for visualizing the uterine cavity and treating intrauterine pathologies.
EVIDENCE ACQUISITION: This review of the literature aims to report the current available data on the effects of the two most common endouterine pathologies (i.e. endometrial polyps and submucous myomas) and the impact of hysteroscopic removal on fertility outcomes.
EVIDENCE SYNTHESIS: To date, the low number of randomized controlled trials available does not yet make it possible to give a definitive answer on what are the reproductive outcomes following treatment of endometrial polyps and leiomyomas. Nevertheless, existing evidence points to a benefit of removal of this two pathologies in infertile women, mostly when they have a history of recurrent pregnancy loss.
CONCLUSIONS: Further studies are needed to demonstrate that surgical treatments of endometrial polyps and myomas could improve not only the morphology but also the function of the uterine cavity before undergoing any
assisted fertility treatment.

KEY WORDS: Endometrial polyps; Submucous myomas; Hysteroscopic polypectomy and myomectomy; Fertility outcomes

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