October 18th, 2018

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Impact on Pregnancy Rates of Endometrial Polyps First Suspected by Vaginal Ultrasound at Cycle Monitoring in Intrauterine Insemination Cycles
Authors:  Olga Ramón, M.D., Ph.D., Haizea Goiti, M.D., Beatriz Corcostegui, B.S., Jorge Burgos, M.D., Ph.D., Oihane Gomez-Picado, B.S., Antonia Exposito, B.S., Ph.D., Iñaki Brouard, M.D., and Roberto Matorras, M.D., Ph.D.
  OBJECTIVE: To ascertain the influence of endometrial polyp–like lesions (EPLLs) discovered during ovarian stimulation for intrauterine insemination (IUI) on pregnancy rates (PRs) and live birth rates (LBRs).

STUDY DESIGN: This study was a prospective controlled study. Patients undergoing IUI with normal pre-IUI hysterosalpingography and pelvic ultrasound were subjected to IUI under gonadotropin stimulation. Those in whom an EPLL was detected in cycle monitoring ultrasound (46 women, 75 cycles) constituted the study group, and those without EPLLs made up the control group (320 women, 512 cycles). PRs and LBRs (per cycle and per woman) were studied. During cycle ultrasound monitoring scans, the endometrium was thoroughly scrutinized in search of EPLLs. Hysteroscopy was performed in women failing to conceive if EPLLs were observed in 2 cycles or in the third cycle.

RESULTS: The EPLL prevalence was 12.57% in the women studied and 12.78% in the cycles in which IUI was performed. PRs and LBRs were very similar in the EPLL and control groups in all categories considered: per cycle (18.67 vs. 22.46% and 16 vs. 18.55%), per first cycle (19.57 vs. 23.75% and 17.39 vs. 20.0%), and per woman (30.43 vs. 35.94% and 26.09 vs. 29.37%).

CONCLUSION: The influence of EPLLs on IUI PRs, if any, is much smaller than previously supposed. When an EPLL is first observed during ovarian stimulation for IUI, the current cycle should not be canceled.
Keywords:  artificial insemination, assisted reproductive techniques, endometrial polyps, hysteroscopy, insemination, intrauterine insemination, ovarian stimulation, polyps, pregnancy rates
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