Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity

Malcolm G. Munro, Munro MG
Fertility and sterility · 2019 · vol. 111(4) , pp. 629–640 · doi:10.1016/j.fertnstert.2019.02.008 · PMID:30929720 · W2933836786
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This study investigated the impact of uterine polyps, adenomyosis, and leiomyomas on endometrial receptivity in women.

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Abstract

Endometrial polyps, adenomyosis, and leiomyomas are commonly encountered abnormalities frequently found in both fertile women and those with infertility. The clinician is frequently challenged to determine which of these entities, when found, is likely to impair fertility, and which are "innocent bystanders" unrelated to the problem at hand. Although removing an endometrial polyp may be seen as a relatively benign and safe intervention, myomectomy, and in particular adenomyomectomy, can be substantive surgical procedures, associated with their own potential for disrupting fertility. One of the mechanisms thought to be involved when these entities are contributing to infertility is an adverse impact on endometrial receptivity. Indeed polyps, adenomyosis, and leiomyomas have all been associated with an increased likelihood of abnormal endometrial molecular expressions thought to impair implantation and early embryo development. This review is designed to examine the relationship of these common entities to endometrial receptivity and to identify evidence gaps that should be considered when strategizing research initiatives. It is apparent that we have the tools necessary to fill these gaps, but it will be necessary to approach the issue in a strategic and coordinated fashion. It is likely that we will have to recognize the limitations of imaging alone and look to the evidence-based addition of molecular analysis to provide the individualized phenotyping of disease necessary for patient-specific treatment decisions.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Embryo Implantation Endometrium Leiomyoma Polyps Uterine Diseases Uterine Neoplasms Adenomyosis Adenomyosis Adenomyosis Adenomyosis Embryo Implantation Endometrium Endometrium Female Humans Infertility, Female Infertility, Female Infertility, Female Infertility, Female

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References (100)

Cited by (50)

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License: CC0 · commercial use OK