Endometrial Polyps Effect on Pregnancy Outcomes in Infertile Women with Minimal/Mild Endometriosis: A Retrospective Study

Background: The infertile patients with endometriosis had a higher prevalence of endometrial polyps. The effect of endometrial polyps on pregnancy outcomes in endometriosis-associated infertility patients is unclear. This study assessed the pregnancy outcomes and associated influencing factors of pregnancy after hysteroscopy combined with laparoscopy treatment in infertile patients with minimal/mild endometriosis. Methods: We enrolled 898 infertile women who underwent both hysteroscopy and laparoscopy treatment. Based on the existence of endometrial polyps confirmed by hysteroscopy and pathologic examination, patients were divided into polyps group and non-polyps group, and their pregnancy outcomes were compared. Results: After removal of 136 subjects who were lost to follow-up, underwent assisted reproduction techniques, or postponed plans to become pregnant. A total of 271 women were included in polyps group and 491 in non-polyps group. The pregnancy rate of polyps group was not statistically significant compared with non-polyp group (60.15% VS. 58.25%). The pregnancy rate was higher among patients with polyps ≥ 1 cm (76.06%, 54/71) than patients with polyps < 1 cm (54.50%, 109/200) or patients without polyps (58.25%, 286/491) (p = 0.006). The pregnancy rate was higher for patients with multiple polyps (67.86%, 95/140) than for patients with single polyp (51.91%, 68/131) or without polyps (p = 0.025). Conclusions: Compared with those without endometrial polyps, single polyp, and size of polyp < 1 cm, hysteroscopic polypectomy did significantly increase fertility in infertile patients with multiple polyps or size of polyp ≥ 1cm. The size and number of polyps were independently associated with the reproductive ability of women with minimal/mild endometriosis.