Reproductive challenges of endometrial polyps: The influence of women's age and associated risk factors

Sladjana Mihajlovic, Svetlana Vujović, Mina Hagen, Milan Lacković, Sanja Milić, Antoan Stefan Šojat, Kristina Saravinovska, Natalija Antić, Đurđica Kaličanin, Ljiljana Marina
In: Medicinska istrazivanja · 2025 · vol. 58(2) , pp. 125–131 · doi:10.5937/medi58-53292 · W4411976693
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Abstract

Introduction / Aim: Endometrial polyps (EPs) are abnormal benign growths that originate from the endometrium. Risk factors associated with EPs are hormonal changes related to ageing, Tamoxifen use, hormone replacement therapy, overweight or obesity. The exact causal relationship between EPs and infertility remains unclear, but multiple mechanisms including mechanical obstruction and biochemical changes are proposed. The "gold standard" for diagnosing and treating EPs is hysteroscopy. This study aims to provide comprehensive understanding of the interplay between EP, age and infertility. Material and methods: Our study included 301 women undergoing hysteroscopic polypectomy due to infertility treatment, which were divided into two groups based on their age (age ≤ 35 and age > 35). Data were collected from patients' medical histories and pathology reports. Study variables included infertility type, type 2 diabetes mellitus, insulin resistance, polycystic ovary syndrome, endometriosis, hypothyreosis, previous unsuccessful intrauterine insemination and in vitro fertilization (IVF), menstrual cycle irregularities and abnormal uterine bleeding, polyp size and histopathology type. Results: At least one out of five participants had insulin resistance, polycystic ovary syndrome and abnormal uterine bleeding. Endometriosis, insulin resistance and primary infertility were more common in the younger group then in the older group. Previous history of unsuccessful IVF cycles, hypothyreosis and secondary infertility were associated with older age. Conclusion: The prevalence of EPs tends to increase with advanced women's age, period marked by natural decline in ovarian reserve, hormonal changes and changes in endometrial health. Addressing EPs through appropriate diagnostic and therapeutic measure and understanding the hormonal influence on EPs and EM is crucial for improving fertility outcomes.

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endometriosisinfertility

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