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SPONTANEOUS PREGNANCY RATE AFTER HYSTEROSCOPIC POLYPECTOMY

SPONTANEOUS PREGNANCY RATE AFTER HYSTEROSCOPIC POLYPECTOMY. 450205. Bueloni-Dias, F.N.; DIAS, R.; DIAS, D.S.; MODOTTI, W.P.; abrão , F.; ELIAS, L.V. Post Graduation Program on Gynecology, Obstetrics and Mastology Botucatu Medical School, São Paulo State University – FMB/UNESP, Brazil.

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SPONTANEOUS PREGNANCY RATE AFTER HYSTEROSCOPIC POLYPECTOMY

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  1. SPONTANEOUS PREGNANCY RATE AFTER HYSTEROSCOPIC POLYPECTOMY 450205 Bueloni-Dias, F.N.; DIAS, R.; DIAS, D.S.; MODOTTI, W.P.; abrão, F.; ELIAS, L.V. Post Graduation Program on Gynecology, Obstetrics and Mastology Botucatu Medical School, São Paulo State University – FMB/UNESP, Brazil Objective: To evaluate hysteroscopicpolypectomy as a method of treating patients with primary and secondary infertility. Design: Retrospective analysis of data obtained from medical records of 54 infertile patients, with the diagnosis of endometrial polyps and otherwise idiopathic primary or secondary infertility, which had undergone surgical polypectomy at the Gynecological Endoscopy Sector from Botucatu Medical School – UNESP, between 2005 and 2010. Measurements & Main Results: The mean age was 32 years (20;45); 61.1% (33/54) had BMI between 20-25 (normal) and 37% (20/54) between 25-30 (overweight); 98.1% (53/54) were non-smokers; 1.9% (1/54) had arterial hypertension; 77.8% (42/54) had primary and 22.2% (12/54) had secondary infertility. Transvaginal ultrasound was normal in 25.9% (14/54)of cases previously the hysteroscopy; 70.4% (38/54) presented imaging suggestive of endometrial polyps; 1.9% (1/54) presented nonspecific endometrial thickness and 1.9% (1/54) presented not submucous fibroid < 2 cm.During the hysteroscopic exam only 13% (7/54) of endometrial polyps were observed on the cornual regions and 40.7% (22/54) were associated with cervical polyps. Only 11.1% (6/54) of the guided biopsy diagnosed endometrial polyps which were all benign, the other findings were compatible with normal endometrium according to the menstrual phase of the cycle. After polypectomy, 98.1% (53/54) presented benign polyps and 1.9% (1/54) atypical polyp. At 12 months follow-up the spontaneous pregnancy rate was 31.4% (17/54) and abortion rate was 29.4% (5/17). Setting: Clinics Hospital from Botucatu Medical School São Paulo State University – UNESP, Gynecological Endoscopy Ambulatory and Surgical Center. Interventions: Retrospective analysis of epidemiological data, clinical features, diagnostic and surgical records, histological aspects of endometrial biopsies and spontaneouspregnancy rate after polypectomy. Conclusion: In all cases of infertility, primary or secondary, the investigation of the uterine cavity is necessary, even if the transvaginal ultrasound is normal. Despite of age, atypical formations may occur. Patients with polyps will benefit from the removal of them with improvement in clinical pregnancy rate, although the effect of asymptomatic endometrial polyps on infertility is still unclear.

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