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Are Fibroids and Polyps Preventing You from Getting Pregnant?

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a blog by David Kreiner, M.D., F.A.C.O.G.

Fertility is dependent upon so many things!

First it must involve healthy gametes (eggs) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. Then, it requires sperm (in sufficient number) that are capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.

The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.

And you wonder why getting pregnant is so hard?

Now, on top of all that, occasionally, an intramural myoma (fibroid in the uterine muscle wall) may obstruct adequate blood flow to the endometrial lining. However, it is the submucosal myoma, inside the uterine cavity, that produces an IUD-like effect of irritating the uterine lining which can prevent implantation. Endometrial polyps (endometrial tissue protruding into the uterine cavity) may have a similar effect.

If your pregnancy is being hindered by these growths, you may need to have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix into your uterus while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.

The hydrosonogram is performed by placing a thin tubular plastic catheter through the cervix into the uterine cavity. Water is injected using a syringe connected to a plastic tube. A patient may feel mild cramping, which is occasionally worse when she has fallopian tube disease or obstruction. Sometimes, at this point, a doctor will also use an embryo transfer catheter and perform an embryo transfer trial in anticipation of an in vitro fertilization (IVF) cycle.

Both polyps and fibroids in the uterine cavity can cause abnormal vaginal bleeding and occasionally cramping. These polyps and fibroids are almost always benign but they may need to be removed to render implantation. An endometrial polyp may be removed by a hysteroscopy, dilatation and curettage procedure. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can often be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus is extremely rare.

Resection of a submucosal myoma is more difficult and is a longer procedure than the polypectomy. It too is performed hysteroscopically, without cutting. Sometimes, especially when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.

Are polyps or fibroids preventing you from getting pregnant?

Though the procedures I’ve described above are no picnic, failure to do them to remove endometrial polyps and submucosal myomata will not only prevent your pregnancy from occurring spontaneously, it will prevent implantation even with IVF!

Comments (11)

hi my husband and i are married four years now and im not able to get pregnant. can i concieve if i have a polyp?

Sunita - each situation is case specific. I recommend that you consult with a fertility specialist to discuss your options. If you need help finding a fertility specialist in your area feel free to email me directly at

JulieH - he mentioned removing the polyp , but I dont have insurance and my Options vary . He said the chlomid might could help with the polyp but from what I'm reading it's just shooting my hopes down lol he seems to get agitated with me on my cycle days because I don't know anything about my cycle because I've never had a Period on my own , I've always had birth control to control my Menses , at that's why I went to him the first time and he said I was barely producing estrogen .

If you do not have insurance you should either consider looking in to getting an insurance plan that can assist you with coverage or the other options they offered you with. If your doctor gets agitated with you I recommend that you seek a second opinion with a different doctor that makes you feel as comfortable as possible. Good luck

I've been tryin to get pregnant for about 2 years now , I don't have periods at all and I've been on chlomid for 2 rounds , today my gyno found a cervical polyp .. Is it Impossible for me to have children ???

Worried - I am so sorry to hear that you are struggling. If your Gynecologist found a cervical polyp you should consider seeing a fertility specialist to see what treatment options you have. If you would like assistance in finding a fertility specialist near you please feel free to email me directly at I am more than happy to assist you.

Hello Sharon - have you seen a specialist regarding your fibroids? If so were you told that they were affecting your ability to conceive? If you need assistance finding a fertility doctor please email me directly at

I have 4 intramural fibroids sizes 44* 33mm to 122*94mm and 74*59mm subserosal fibroids on the upper anterior wall and the larger fibroid is located on the anterior walls

My husband and I have been married 10 yrs. now and have not been able to conceive. We have been in and out of doctors offices too numerous to count and they still don't know what is wrong.
Thank you for this post I will bring this up during my next appointment and see if this is something they may have over looked.

My health care provider told me once that this can cause abortion or miscarriage to a pregnant woman. This is the reason why it is essential to consult a physician before planning to have a baby so as to prevent any problem in the future.


I am male, 34 and my wife is 35 years old. we are married for over 2 years and still no luck in conceiving babies. My wife's reports are OK. I have my semen analysis result which i am posting below...

Volume: 3 ml
Color: Opaque Grey
pH: 8.0
Viscosity: Completed Self Liquefaction: Liquid:>30 Minutes
Sperm Count: 336 million/ml
Pus Cell: 3-4
Histiocytes: Absent
RBCs: Absent
Yeast/Bacteria: Absent
Immature Form: Spermatids+
Agglutination: Positive
Clumping: Positive
abnormal Forms: <10%
Active Motile: 20%
Sluggish Motile: 05%
Non Motile: 75%

Can you please recommend medication for me.


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