Endometrial Polyps: Identifying Silent Obstacles to Pregnancy
Dr. Prof (Col) Pankaj Talwar, VSM, MD, PhD
Uterine Health & IVF Specialist | Reg: HMC-HN 16822
Endometrial polyps are localized overgrowths of the uterine lining. While usually benign, they act like a “natural copper-T” or contraceptive device inside the uterus. If you are struggling to conceive or facing repeated IVF failures, a small polyp might be the hidden cause.
Sonographic Appearance of Polyps
On a standard Transvaginal Ultrasound (TVS), a polyp appears as a well-defined, echogenic (bright) mass within the endometrial cavity. To confirm the diagnosis, we look for two specific markers:
- The Feeding Vessel (Pedicle Artery Sign): Using Color Doppler, we can often see a single artery supplying blood to the polyp. This distinguishes it from a fibroid, which usually has a circular blood supply.
- Intracavitary Fluid: Sometimes, natural fluid in the uterus helps outline the polyp, making it easier to see.
Saline Infusion Sonography (SIS)
When a standard scan is inconclusive, we perform an SIS (Water Scan). We gently infuse sterile saline into the uterine cavity during the ultrasound. The water “inflates” the cavity, allowing us to see exactly where the polyp is attached and how much space it is occupying.
Why Polyps Hinder Pregnancy:
- Mechanical Barrier: They physically prevent the embryo from touching the uterine wall.
- Inflammatory Response: Polyps can cause a localized inflammatory reaction that is toxic to embryos.
- Bleeding: They often cause “intermenstrual spotting,” which disrupts the ideal environment for implantation.
Management: Hysteroscopic Polypectomy
At Talwar Fertility & Child Health Centre, we recommend removing polyps larger than 10mm or any polyp found in a patient with unexplained infertility. This is done via Hysteroscopy—a “no-cut” procedure where we use a tiny camera to enter the uterus and remove the polyp under direct vision. This significantly boosts natural and IVF pregnancy rates.
Optimize Your Uterine Receptivity
Ensure your uterus is ready for pregnancy. Schedule an advanced 3D scan or SIS with Dr. Pankaj Talwar today.
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