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Minerva Obstetrics and Gynecology 2022 February;74(1):3-11

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


lingua: Inglese

Fertility outcomes after hysteroscopic removal of intrauterine leiomyomas and polyps

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

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. 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. 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 these two pathologies in infertile women, mostly when they have a history of recurrent pregnancy loss. 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: Endometrium; Polyps; Uterine myomectomy; Fertility

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