Many years of infertility, it turned out to be the endometrium polyps

There are many patients with infertility in clinical practice. The most common causes are poor sperm, cannot oxide, fallopian tubes, and so on.

However, there are a type of patients who have no problems in these aspects. However, when the B -ultrasound is tested, it is found that there is an endometrium polyps in the uterine cavity, and it is precisely that this small thing affects conception.

The endometrium polyps consist of the endometrium gland, which is composed of interstitial and blood vessels. The size is different. The small ones are only a few millimeters. The larger ones can be 2-3cm, occupying the entire uterine cavity.There are also many or less, and their looks are different.

The endometrium polyps seen under uterine hysteroscopy

The endometrium polyps seen under uterine hysteroscopy

The specific cause is not very clear. Some studies have found that it may be related to these factors, including chronic inflammatory stimuli, age, hypertension, obesity, and his Momoxifen (a drug after breast cancer).

Most of the time, the endometrium does not cause any uncomfortable symptoms. A few may have abnormal vaginal bleeding. It may be because it affects the area of the endometrium, which causes uneven thickness of the endometrium, and extension is not synchronized.

The endometrium polyps are almost benign and rarely cancer.However, if the endometrial polyps appear after menopause and vaginal bleeding, the danger will be greater.

Successful pregnancy requires conditions to meet the requirements. The endometrium of the uterine cavity is where the embryo grows. This bed is needed to be large enough, and Xi Mengsi is soft enough.

Normal uterine morphology under uterine hysteroscopy

If there is a polyp on the endometrium, a bump, the fertilized eggs come here, there is no bed, causing infertility.Even if it is planted, there may be problems with blood supply, causing embryos to stop and abortion.

For the uterine cavity, polyps can be regarded as a foreign body, which is a bit like a birthplace, which will cause chronic inflammatory reactions in the surrounding endometrium. There are more inflammatory factors, which will also affect the successful bed.

Of course, if the polyps are not very large, or the endometrium near the bottom of the palace, there is enough normal endometrium, which can also be pregnant.

If there are abnormal uterus bleeding, it is similar to endless menstruation, vaginal bleeding after menstruation, etc., or patients with infertility, you must check whether there is endometrial polyps.

The conventional gynecological examination is at most to see the cervix to the end.Therefore, it is impossible to diagnose whether there are endometrium polyps.

What we can use is B -ultrasound. Most of the polyps of more than 1cm can be discovered by Yin Chao, and sometimes a few millimeters of one.B -ultrasound is cheap and free of radiation, the most clinical application.Of course, you can also use CT and MRI to judge, which is a bit expensive.

The endometrium polyps seen in the B ultrasound (referred to by the arrow)

Sometimes the patient is due to infertility for fallopian tubal angiography, and the results show that there is a filling defect in the uterine cavity, indicating that the polyps may be polyps.Or do you find that the endometrium is still growing polyps.

Of course, none of these examinations can be diagnosed with endometrial polyps. Sometimes it may be small mucosal fibroids. The only pathological examination can only be diagnosed. This requires a hysteroscopic surgery to remove the polyp.

If you are infertile patients, you can find endometrial polyps. Regardless of the size of the polyp, you can consider doing hysteroscopy. When you check the shape of the uterine cavity, you can remove polyps and tubal fluid. If necessaryThe pelvic lesions.Even if you are considering a test tube baby, it is recommended to remove the polyps in hysteroscopy first.

If there are abnormal uterine bleeding, it is also recommended to remove endometrial polyps.However, it is not recommended for traditional curetics, because many times the polyps cannot be completely removed.We recommend doing endometrial polyps and scratching under the uterine laparoscopy.

If there is nothing uncomfortable, no bleeding and infertility, the polyp is less than 1-1.5cm, and you can do nothing, and review it regularly.25%of endometrium polyps can disappear by themselves, the smaller the probability of disappearing.Even if you get a little bigger, you can consider reviewing Yin Chao on the 5-6th day of the next menstrual period, which may disappear.

Why does the polyp disappear by yourself?These polyps are seen by B -ultrasound, which may not be the real polyps, but the endometrium hyperplasia. The B -ultrasound looks like polyps.Check Yin Chao on the 5-6th day of menstruation, so as not to increase the endometrium to thicken the impact judgment.It may indeed be that the polyp itself has become smaller, and it is not as small as Yin Chao.

Drugs such as oral contraceptives, Manyuele Ring, and GNRHA may have certain effects, which can control polyps and prevent recurrence. However, there is also lack of clear evidence and other side effects.Therefore, it is not commonly recommended in clinical practice.

Congratulations, it means that the polyp is harmless to you.Postpartum follow -up B -ultrasound.

The endometrium polyps have a certain recurrence rate, which really relapses, and it is also based on this prevention plan.

Cut the uterus!Do you want to!

In short, if the uterine endometrial polyps are small and there are no symptoms, it can not be treated; if you need to treat it, hysteroscopy is recommended.

Author: Chief Physician Zou Shien, Affiliated to Obstetrics and Gynecology Hospital of Fudan University

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