Impact of newly diagnosed endometrial polyps during controlled ovarian hyperstimulation on in vitro fertilization outcomes

Abstract

Study objective: To investigate the impact of newly diagnosed endometrial polyps during controlled ovarian hyperstimulation (COH) on the outcomes of fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles.

Design: A retrospective cohort study (Canadian Task Force classification II-3).

Setting: An academic center.

Patients: All patients initiating IVF cycles at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine during a 1-year period. Patients were stratified into 2 groups based on the presence or absence of newly diagnosed endometrial polyps during COH.

Interventions: IVF with fresh ET.

Measurements and main results: Two thousand nine hundred ninety-three patients were identified: 60 in the polyp group and 2933 in the nonpolyp group. The overall positive pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth rates were similar between the groups. The biochemical pregnancy rate was 18.3% in the polyp group compared with 9.6% in the nonpolyp group (p = .01). This represented a 2-fold increased odds of biochemical pregnancy in the polyp group (odds ratio = 2.12; 95% confidence interval, 1.09-4.12) compared with the nonpolyp group.

Conclusion: Newly diagnosed endometrial polyps during COH is associated with an increased biochemical pregnancy rate but ultimately does not adversely impact clinical pregnancy or live birth rates after fresh IVF-ET.

Keywords: Controlled ovarian hyperstimulation; Endometrial polyps; In vitro fertilization; Live birth; Miscarriage; Uterine receptivity.