The prevalence of endometrial polyp in women with tubal factor infertility is higher than male factor infertility: Is PID one of the causes of endometrial polyp?

J Obstet Gynaecol Res. 2023 Feb;49(2):658-664. doi: 10.1111/jog.15485. Epub 2022 Nov 30.

Abstract

Aims: Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps.

Methods: This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report.

Result: In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 [60%] vs. 12 [9.8%]), and this difference was statistically significant (p = 0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 [18.8%] vs. 4 [3.3%]), and this difference was statistically significant (p = 0.001).

Conclusions: In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.

Keywords: female infertility; male infertility; pelvic inflammatory diseases; polyp; uteri.

MeSH terms

  • Case-Control Studies
  • Endometritis* / complications
  • Fallopian Tube Diseases* / complications
  • Fallopian Tube Diseases* / epidemiology
  • Female
  • Humans
  • Hysteroscopy / adverse effects
  • Infertility, Female* / diagnosis
  • Infertility, Female* / epidemiology
  • Infertility, Female* / etiology
  • Male
  • Polyps* / complications
  • Polyps* / diagnosis
  • Polyps* / epidemiology
  • Pregnancy
  • Prevalence