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Sometimes, the answer lies in something small and silent: endometrial polyps.
These tiny growths inside the uterus are often missed. They may not cause pain or heavy bleeding. But they can quietly stand in the way of your pregnancy plans.
Let’s understand what they are, why they happen, and what to do if they’re affecting your fertility.
What Are Endometrial Polyps?
Endometrial polyps are benign, localized overgrowths of the endometrial tissue lining the uterus. These growths are usually non-cancerous and can be as small as a seed or as large as a grape.They hang from the uterine wall and are sometimes attached by a stalk (these are called pedunculated polyps). You might have one or several at the same time. Some women never know they have them.
Can Endometrial Polyps Affect Fertility?
Yes, and here’s why.Even though they’re benign, polyps can:
- Block the entrance of the fallopian tubes, preventing sperm from reaching the egg
- In some cases, they create inflammation in the uterus, which may interfere with the embryo’s ability to implant
- Change the shape of the uterine cavity, disrupting implantation or early pregnancy
- Interfere with hormone signals that guide pregnancy processes
Symptoms to Watch For
Many women with polyps have no symptoms. That’s why many women don’t even know they have them until they go in for fertility testing or an ultrasound.When symptoms do appear, they can include:
- Irregular or heavy menstrual bleeding
- Bleeding between periods
- Spotting after sex
- Mild cramps
- A feeling of “fullness” in the lower abdomen
- Trouble getting pregnant (with no clear cause)
Why Do Polyps Happen?
Doctors don’t always know the exact reason. But several risk factors increase your chances of developing polyps:- Age 40 and above
- Hormonal imbalances, especially excess estrogen
- Taking tamoxifen (a medication for breast cancer)
- Obesity
- Hormone replacement therapy
- Family history
How Are Polyps Diagnosed?
Your doctor may suspect polyps based on symptoms or during fertility assessments. Here's how they confirm the diagnosis:1. Transvaginal Ultrasound
This imaging test lets doctors look inside your uterus. Polyps may appear as thickened areas or abnormal growths.2. Saline Infusion Sonography (SIS)
A special type of ultrasound is done with sterile saline inserted into the uterus. It helps doctors see any unusual tissue more clearly, making diagnosis easier.3. Hysteroscopy
It’s basically a tiny tube with a light that goes in through the vagina. This allows the doctor to see and even remove polyps during the same procedure.4. Biopsy or D&C (Dilation and Curettage)
Tissue is taken from the uterus and tested to rule out cancer or other abnormalities.Are They Dangerous? Can Polyps Be Cancerous?
In most women, especially those who have premenopause, polyps are non-cancerous. However, in women who are postmenopausal or have unusual bleeding, the risk of malignancy increases slightly.It’s always a good idea to have any suspicious polyp removed and tested, just to be safe. Early treatment means early peace of mind.
How Are Polyps Treated?
Treatment depends on your symptoms, age, fertility goals, and polyp size.1. Watchful Waiting
If you’re not having symptoms and not trying to get pregnant, your doctor may suggest keeping an eye on the polyps with regular ultrasounds. Some polyps go away on their own.2. Hysteroscopic Polypectomy
This is the most common treatment. The doctor inserts a tiny camera through your cervix and removes the polyp without any cuts or stitches. It’s usually a same-day procedure.3. Hormonal Medications
Hormonal treatments like birth control pills may help manage symptoms, but they don’t always shrink polyps.4. Hysterectomy
This is rarely needed, only in complex or high-risk cases when other treatments fail, or if the polyps keep coming back.Should You Be Concerned If You're Trying to Conceive?
If you’ve been trying for more than 6-12 months without success, or if your doctor suspects a uterine issue, it’s worth checking for polyps. You deserve answers, and sometimes, the smallest thing can make the biggest difference.Endometrial polyps may not scream for attention. But they can quietly stand between you and the pregnancy you’re hoping for.
The good news? It might feel overwhelming, but these are some of the simpler things to diagnose and treat.
If you're facing unexplained infertility, abnormal bleeding, or simply need clarity, talk to your gynecologist. You know your body, and asking questions is the first step toward getting answers.
FAQs on Endometrial Polyps: A Hidden Cause of Infertility
- When can I get back to normal activities?
Usually the next day. Mild spotting is normal for a few days. - Does it help with fertility?
Yes. Removal often boosts chances, especially if you have unexplained infertility or failed IVF cycles. - When can I try to conceive again?
Often after your next period but follow your doctor’s advice.
