Do uterine polyps affect your fertility? What you need to know

When you’re trying to conceive, it’s natural to focus on your ovulation cycles, hormone levels, and lifestyle habits. However, one often-overlooked cause of fertility challenges is the presence of uterine polyps. These small growths in the womb may be benign, but they can significantly impact your chances of getting pregnant.

At McKeown Medical, we understand how frustrating fertility issues can be. This article will help you understand what uterine polyps are, how they might affect your fertility, how they’re diagnosed, and what treatment options are available.

Uterine polyps (also known as endometrial polyps) are small, soft growths that develop in the lining of the uterus. They are made up of the same tissue as the uterine lining, but grow in a way that protrudes into the uterine cavity. While most are benign (non-cancerous), they can vary in size from a few millimetres to several centimetres and may occur singly or in clusters.

There are two main types:

• Endometrial polyps – These grow inside the uterus.
• Cervical polyps – These develop on the cervix but are less commonly linked with fertility issues.

How common are they?

Uterine polyps are relatively common, particularly in women aged 30 to 50, and especially those experiencing hormonal fluctuations. It’s estimated that around 10%–24% of women in this age group may develop them.

Symptoms to watch out for include:

• Irregular menstrual bleeding
• Spotting between periods
• Heavier or longer periods
• Bleeding after intercourse
• Difficulty conceiving

In many cases, however, polyps may cause no symptoms at all and are only discovered during fertility investigations or routine scans.

What causes them?

The exact cause isn’t always clear, but uterine polyps are linked to hormonal imbalances, particularly excess oestrogen. Factors such as obesity, age, and the use of certain medications (such as tamoxifen) may also increase your risk.

So, how exactly do uterine polyps affect fertility?

These growths can interfere with your ability to conceive in several ways:

Blocking embryo implantation

Polyps that occupy the uterine cavity can disrupt the environment where an embryo would normally implant and develop. Even small polyps in key locations may reduce the chances of successful implantation.

Obstructing sperm transport

Depending on their size and position, polyps can physically interfere with the passage of sperm through the uterus, reducing the likelihood of fertilisation.

Triggering inflammation

Polyps may cause subtle, chronic inflammation in the uterus, which can create a less hospitable environment for embryo development.

Not all polyps pose a threat to fertility, but those that are large, multiple, or located near the uterine fundus (top portion of the uterus, where implantation often occurs) are more likely to be problematic.

It’s important to note that while there’s a clear association between polyps and infertility, this doesn’t mean every polyp causes infertility. However, removing polyps, especially in women undergoing fertility treatments like IVF, has been shown to improve pregnancy rates significantly.

If you’re experiencing symptoms or struggling to conceive, it may be worth investigating whether polyps could be a factor.

Diagnosis options include:

• Transvaginal ultrasound: This is a first-line imaging tool, but small or flat polyps may be missed.
• Saline Infusion Sonohysterography (SIS): Involves injecting sterile saline into the uterus to provide a clearer ultrasound image of the uterine cavity. This is more sensitive than standard ultrasound.
• Hysteroscopy: This is the gold standard. A thin, lighted telescope is inserted through the cervix, allowing direct visualisation (and often removal) of polyps in one procedure.

Routine pelvic exams or abdominal ultrasounds are unlikely to detect uterine polyps effectively, especially if they are small or asymptomatic.

The good news is that uterine polyps can be effectively treated, often with minimal downtime and excellent outcomes for fertility.

Common treatment options include:

Hormonal treatments

Medications like progestins or GnRH agonists may temporarily reduce polyp size, but are generally less effective for long-term management and are not typically recommended when fertility is a concern.

Hysteroscopic polypectomy

This is the most definitive treatment. It allows for precise removal of polyps under direct visualisation, often in a day-case setting. Recovery is generally quick, with most women returning to normal activities within a few days.

MyoSure® procedure

Offered at McKeown Medical, this minimally invasive technique removes polyps while preserving the surrounding uterine tissue. It’s particularly useful for women planning to conceive, as it maintains uterine integrity.

What to expect after treatment:

• Improved fertility outcomes: Studies have shown that removing uterine polyps can increase pregnancy rates, especially in women undergoing IVF.
• Low recurrence: Most women experience good results, but polyps can recur. Regular follow-up and monitoring are important, particularly if you have underlying hormonal imbalances.
• Personalised care: Your treatment will depend on factors like age, fertility goals, and whether you’re undergoing assisted reproduction.

Uterine polyps are a common but often overlooked cause of infertility. Fortunately, with the right diagnosis and expert treatment, most women can go on to conceive successfully.

At McKeown Medical, we specialise in women’s health and fertility, offering state-of-the-art diagnostics and advanced treatments including hysteroscopy scans and MyoSure® care, led by our experienced consultant gynaecologist, Dr Iain Martin.

Whether you’re actively trying to conceive, undergoing fertility treatment, or simply want peace of mind, we’re here to help.

Book a health consultation today to get started on your journey to better gynaecological health.