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Understanding Uterine Polyps and Fibroids

Both fibroids and polyps are growths that can develop within the uterus, but differ in terms of their composition, location, symptoms, and potential health risks. Understanding the difference between polyps and fibroids can help you make more informed decisions about your health and treatment options.


In this blog post, we'll explore the key distinctions between these two types of uterine growths and how they may impact your fertility.

woman in pain in bed
Polyps and Fibroids can impact your life and fertility
What Are Polyps?

Uterine Polyps are small, benign (non-cancerous) growths that develop within the inner lining of the uterus, also known as the endometrium. These growths are typically composed of endometrial tissue and can vary in size, ranging from a few millimeters to several centimeters. While polyps tend to be non-cancerous, they have the potential to become cancerous, specifically in post-menopausal women (1).


What are Fibroids?

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop from the muscle tissue of the uterus. These growths can very in size, ranging from small, seed-like growths to large masses within the uterine wall (intramural), protrude outward from the uterus (subserosal), or attach to the inner lining of the uterus (submucosal).


Key Differences Between Polyps and Fibroids
Composition
  • Polyps are made of endometrial tissue

  • Fibroids are made of muscular tissue

Location
  • Polyps are located in the Endometrium

  • Fibroids can be located throughout the uterus

Size
  • Polyps are small in size

  • Fibroids are large in size

Symptoms
  • Polyp symptoms can include bleeding, irregular cycles, and infertility

  • Fibroids symptoms can include bleeding, prolonged periods, pelvic pain, frequent urination, and constipation

Risk of Cancer
  • Polyps are often benign, however there is a small risk of malignancy (presence of cancer)

  • Fibroids are benign in nature


Diagnosis and Treatment

Both polyps and fibroids can be diagnoses through imaging tests such as ultrasound, MRI, or hysterectomy. Treatment options may vary depending on the size, location, symptoms, and individuals overall health. Options include watchful waiting, medications, minimally invasive procedures, or surgical removal.


Surgical Methods of Treatment
  • Polyps can be removed with a polypectomy

  • Uterine fibroids can be removed surgically with a myomectomy, also known as a "fibroidectomy."


Both procedures may be performed either by a gynecological surgeon or a reproductive endocrinologist.


Impact on Fertility

While many women with polyps and fibroids may conceive and have successful pregnancies, these uterine growths can sometimes interfere with fertility and reproductive health.


How Polyps Impact Fertility
Disruption of Implantation
  • The mechanism by which polyps interfere with implantation is unclear (2), however studies suggest polyps may cause inflammation similar to an Intrauterine Device creating a suboptimal environment for implantation and fetal development.

Biochemical Effects
  • The presence of uterine polyps may increase the presence of inflammatory markers causing an imbalance in the environment of the endometrium (3).

Mechanical Obstruction
  • In rare cases, large polyps may obstruct the fallopian tubes or cervix, preventing the sperm from reaching the egg and fertilization from occurring (3).


How Fibroids Impact Fertility

Fibroids are present in 5-10% of women struggling with infertility (4). Fibroids impact fertility by:

Distorting the Uterine Cavity
  • Fibroids can alter the shape and size of the uterus, potentially affecting the sperm's ability to reach the egg, the implantation of a fertilized egg, or the growth and development of the fetus during pregnancy. It is important to note that where a fibroid is situated impacts embryo transfer outcomes (5).

Limited Blood Supply
  • Large fibroids may interfere with the blood supply to the uterine lining, affecting its thickness and receptivity, which can impact implantation and increase the risk of miscarriage.

Compression of Fallopian Tubes
  • Subserosal or intramural fibroids may compress or distort the fallopian tubes, preventing the egg from traveling to the uterus and decreasing the chance of fertilization.


Discussing With Your Doctor

If you suspect that polyps or fibroids may be contributing to your struggle to conceive, it is important to discuss your concerns with you OBGYN and/or fertility specialist. It may be overwhelming and you may feel unsure where to begin. This is where we can help. Here are a few tips to help.


Track Your Symptoms

It is important to log any symptoms you are experiencing in detail, such as:

  • Detailed description of symptoms

  • How long the symptoms last

  • Write down when they began and keep track of how long they last

  • How intense your symptoms are


Questions to Ask Your Doctor
  • Ask your doctor to differentiate what is normal and what is not.

    • It is important to be forceful In explaining if something doesn't feel right. Remember, severe pain or other symptoms that impacts your daily life is not normal and should be communicated to your doctor rather than just dismissed

  • What will happen if you do not seek treatment?

  • What are the least Invasive to most Invasive treatment options available?

  • How long will take me to recover from each treatment and proceed to accomplish my fertility goals?

The good thing is you can use the Grain Fertility application to keep all of this in one place.


Capturing Your Medical History

The Grain Fertility application lets you upload and track any testing, results, or diagnosis from any of your doctors so you always have accurate, timely information available to help you and your doctor accurately discuss your history.


Using Ongoing Tracking Features

The ongoing tracking feature in the application lets you write down your signs and symptoms, capturing in real time what you are feeling so you can accurately convey them to your doctor. You can also use this as a way to write down questions you have before any appointments.


Patient Empowerment Coaching

If you have any further questions or need assistance, don't hesitate to reach out to your Patient Empowerment Coach. We can help you create a customized set of questions, track your symptoms, and help explain the confusing parts of your journey. If you are not a Grain Fertility Premium Member, you can sign up here or if you are a member using our free version, go to your Account to upgrade your service.


Our coaching can offer personalized advice and support tailored to your specific needs and circumstances. Trust in their expertise and lean on them for assistance whenever needed. With proper preparation and support, you can navigate the fertility treatment process with confidence and peace of mind.


Early detection and intervention can help optimize your fertility outcomes, enhance your reproductive health, and increase the chances of achieving a successful pregnancy. Managing polyps and fibroids alongside the daily challenges of your fertility journey can indeed be daunting. Rest assured, our Patient Empowerment Coaches and staff at Grain Fertility are dedicated to guiding and supporting you through every phase of your journey.



References: 

  1. Wong M, Thanatsis N, Nardelli F, Amin T, Jurkovic D. Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis. Diagnostics (Basel). 2021 Jun 15;11(6):1094. doi: 10.3390/diagnostics11061094. PMID: 34203810; PMCID: PMC8232598.

  2. Jee BC, Jeong HG. Management of endometrial polyps in infertile women: A mini-review. Clin Exp Reprod Med. 2021 Sep;48(3):198-202. doi: 10.5653/cerm.2020.04119. Epub 2021 Jul 30. PMID: 34352167; PMCID: PMC8421660.

  3. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019 May 2;7:2050312119848247. doi: 10.1177/2050312119848247. PMID: 31105939; PMCID: PMC6501471.

  4. Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach. Obstet Gynecol Clin North Am. 2012 Dec;39(4):521-33. doi: 10.1016/j.ogc.2012.09.005. PMID: 23182558; PMCID: PMC3608270.

  5.  Ezzati M, Norian J, Segars J. Management of uterine fibroids in the patient pursuing assisted reproductive technologies. Women's Health (Lond Engl) 2009;5:413–21



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