A
patient who had been advised IVF treatment
found during her pre-IVF treatment workup that she had a five millimeter
endometrial polyp in her uterus. Another IVF doctor she had gone to had advised
her to get the polyp removed before getting her IVF treatment. This patient came to Malpani clinic for a second opinion from me.
In
cases like this, it is hard to make definitive decisions. Each doctor has a
subjective opinion of issues like this which fall in the grey areas of medical
practice. Most doctors do believe in removing anything from the uterus before
putting an embryo inside the endometrial cavity . Naturally, they suggested she
get an operative hysteroscopy to get the polyp removed prior to the IVF cycle. This being a standard and
logical approach , is usual medical advice.
On the
other hand, many doctors consider this move unnecessary as there is no evidence
that a small polyp affects embryo implantation. Since, there is insufficient
clinical evidence for a concrete conclusion to be made, this issue remains
controversial. IVF specialists tend
to see only infertile women and they are quite likely to assume that if a woman
has uterine polyps, that these are the cause of her infertility and will
therefore, suggest their removal. However, contrary to this belief, it is a fact
that even fertile women can have endometrial polyps and can get pregnant even
if these are left alone. Since, they don’t have a fertility problem in the
first place , neither they nor the doctor ever discover it.
This
leaves both the doctor and the patient in a state of confusion. The patient
gets contradictory advice from different experts. One advocates surgery, the
other advises her to leave the polyps alone. What is she to do?
Are you
confused as well ? Do you need an objective
high quality second opinion from an IVF expert ? Please send me your medical
details by filling in the form at www.drmalpani.com/malpaniform.htm
so that I can guide you better !
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