Endometrial polyps are one of the uterine findings that may come up during a fertility scan or hysteroscopy. For some patients, they are found while investigating irregular bleeding. For others, they are discovered during fertility evaluation before IUI, IVF or embryo transfer.
A polyp does not always mean that pregnancy is impossible. However, because polyps can develop inside the uterine cavity, they may be relevant when assessing whether the uterus is ready for implantation.
At Janini IVF, endometrial polyps are reviewed as part of the complete fertility picture. The decision to monitor, investigate or remove a polyp depends on its size, location, symptoms, fertility history and treatment plan.
The endometrium is the inner lining of the uterus. This is the lining that changes during the menstrual cycle and is prepared for embryo implantation during pregnancy.
An endometrial polyp is a soft tissue growth arising from this lining. It may be small or larger, single or multiple. Some polyps may not cause any symptoms, while others may be linked with irregular bleeding or fertility concerns.
Because polyps are located within the uterine cavity, they may sometimes affect the space where an embryo is expected to implant. This is why they are considered carefully during fertility treatment planning.
Endometrial polyps may be suspected during a transvaginal ultrasound scan. In some cases, the scan may show a thickened or irregular area within the uterine lining. In other cases, the finding may be unclear and further evaluation may be advised.
Polyps may also be identified during hysteroscopy, where the inside of the uterus is seen directly.
Patients may be evaluated for polyps if they have:
irregular bleeding
spotting between periods
heavy periods
difficulty conceiving
previous failed embryo transfer
recurrent miscarriage concerns
an unclear scan finding within the uterine cavity
Some patients may have no symptoms at all. The polyp may only be found because a uterine assessment is being done before fertility treatment.
Endometrial polyps may affect fertility when they interfere with the uterine cavity or the endometrial lining.
The embryo needs to implant in the lining of the uterus. If a polyp is present inside the cavity, it may disturb the surface of the lining or occupy space within the cavity. This may be relevant when planning natural conception, IUI, IVF or embryo transfer.
However, the effect of a polyp depends on the individual case. Its size, location and number matter. The patient’s age, symptoms, previous pregnancy history and fertility treatment plan also matter.
A small polyp found incidentally may be approached differently from a larger polyp seen in a patient preparing for embryo transfer.
Before IVF or embryo transfer, the uterine cavity is assessed to ensure that there are no findings that may interfere with implantation.
If an endometrial polyp is suspected, the fertility team may consider whether it should be removed before embryo transfer. This is especially relevant if the polyp appears to be inside the cavity or if there have been previous unsuccessful transfers.
The aim is to give the embryo the best possible uterine environment for implantation. This does not mean that every patient with a polyp has the same treatment plan. It means the finding should be assessed carefully before proceeding.
A failed IVF cycle can happen for many reasons. Embryo quality, age, ovarian reserve, sperm factors, uterine factors, endometrial lining and transfer-related issues may all need to be reviewed.
If good embryos have been transferred but implantation has not occurred, the uterine cavity may need closer assessment. A polyp inside the cavity may be one of the findings considered during this review.
This does not mean that the polyp is always the reason for failed IVF. It means it should not be ignored if it is present and relevant to the cavity.
Not every polyp needs urgent treatment, but many polyps found during fertility planning need careful review.
Removal may be considered if:
the polyp is inside the uterine cavity
the patient is planning IVF or embryo transfer
there is irregular bleeding
there have been previous failed transfers
there are recurrent miscarriage concerns
the scan finding is persistent or unclear
the fertility specialist feels it may affect implantation
In selected cases, hysteroscopy may be advised. Hysteroscopy allows the doctor to look inside the uterine cavity directly and remove the polyp if needed.
Hysteroscopic polyp removal, also called polypectomy, is a procedure in which the polyp is removed from inside the uterus using hysteroscopy.
The advantage of hysteroscopy is that the doctor can directly see the uterine cavity. This helps confirm the finding, remove the polyp and assess whether the rest of the cavity appears normal.
For fertility patients, this can be useful before embryo transfer if the polyp is thought to affect the cavity.
Hysteroscopy is not required for every scan finding. It is considered when the finding is clinically relevant and when the fertility specialist feels it may help treatment planning.
Some patients may develop polyps again. This is why follow-up depends on the patient’s symptoms, fertility plan and treatment timeline.
If a patient is actively preparing for IVF or embryo transfer, the fertility team may want to ensure the cavity is suitable before proceeding. If the patient is not immediately starting treatment, the approach may be different.
The timing of treatment should be individualised.
Endometrial polyps may sometimes be associated with abnormal bleeding. This may include spotting between periods, heavy bleeding or irregular bleeding.
Bleeding symptoms do not always confirm that a polyp is present, and a polyp does not always cause bleeding. However, when bleeding symptoms and fertility concerns are present together, uterine evaluation becomes important.
A fertility assessment helps decide whether the polyp is likely to be relevant and whether it should be treated before pregnancy planning.
At Janini IVF, endometrial polyps are assessed as part of the complete fertility evaluation. The focus is not only on finding the polyp, but on understanding whether it matters for the patient’s fertility plan.
The team may review:
ultrasound findings
symptoms and bleeding history
previous fertility treatment
previous pregnancy or miscarriage history
endometrial lining appearance
whether IVF or embryo transfer is planned
whether hysteroscopy is needed
This helps avoid both unnecessary treatment and missed cavity-related findings.
For some patients, removing a polyp before embryo transfer may be appropriate. For others, the finding may be monitored or reviewed alongside other fertility factors.
If your scan report mentions an endometrial polyp, it is important to understand whether it is likely to affect your fertility treatment plan.
At Janini IVF, we assess polyp findings along with your symptoms, scan report, fertility history and previous treatment outcomes to decide whether further evaluation or hysteroscopic treatment may be needed before IUI, IVF or embryo transfer.
Can endometrial polyps affect fertility?
Endometrial polyps may affect fertility if they are inside the uterine cavity or interfere with the lining where implantation occurs.
Should polyps be removed before IVF?
Polyps may be removed before IVF if they are likely to affect the uterine cavity or embryo transfer planning.
Can polyps cause irregular bleeding?
Yes. Endometrial polyps may cause spotting, heavy bleeding or irregular periods, though some patients have no symptoms.
How are endometrial polyps treated?
Endometrial polyps may be removed through hysteroscopy when treatment is clinically advised.
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