Title : Improving diagnosis and treatment for endometrial polyp in patients with infertility after polipectomy
Abstract:
Background: The incidence of endometrial polyps has reached 25–35% making them the most common intrauterine pathology. Polyps account for every fourth hysteroscopy due to their association with abnormal uterine bleeding, infertility and malignancy risks. Absolute or relative hyperestrogenism are important factors in the development of endometrial polyp. Infectious and immune mechanisms have recently acquired special attention with the polyp pathogenesis.
Objective: Management optimisation of infertile patients with endometrial polyp through dif- ferentiated choice of postoperative therapy.
Methods: We examined 90 patients of reproductive age (36.07 ± 6.14 years) with endometrial polyp and infertility conducting a comprehensive history analysis, assessment of reproductive function, extragenital and gynaecological pathology. Laboratory analyses comprised clinical and biochemical blood tests including vitamin and ferrum. Immunohistochemical endometrial estimators were CD16+, CD56+, HLA–DR(II)+.
Results: In total, there were 104 808 live births; 18 121 (17.29%) children died as under-5s and 86 687 (82.71%) survived. Poverty, number of children ever born in a household, number of under-5s in the household, place and region of residence, maternal and paternal age, and maternal and paternal education level were critical determinants of under-5 mortality.
Conclusion: The success rate of natural cycle pregnancy in patients of reproductive age with endometrial polyp after polypectomy is directly related to type of endometrial inflammation: chronic autoimmune, chronic exacerbated or acute endometritis. Immunohistochemical es- timators can be used for differentiating therapy, which allowed a 70.3% pregnancy success rate.
