Optimal time interval between hysteroscopic polypectomy and frozen-thawed blastocyst transfer: A retrospective study

Abstract

The optimal timing of frozen-thawed blastocyst transfer following hysteroscopic polypectomy is an important and unanswered clinical question. In this study, we conducted a retrospective survey of cases from an infertility center at an academic hospital. We reviewed the charts of all patients who received in-vitro fertilization and frozen-thawed blastocyst transfers (FBT) at the center from January 2009 to November 2019. One hundred and two patients with prior diagnosis of endometrial polyp that were treated with hysteroscopic polypectomy before received their first FBT at the center were identified as cases. Patients without prior diagnosis of endometrial polyp, and who received their first FBT at the center were defined as controls. Controls were enrolled at a 1-to-1 ratio to the cases. The cases and controls did not show differences in baseline characteristics, endometrial thickness, or the number of good blastocysts transferred. The clinical pregnancy rates and live birth rates were similar. Regarding the optimal interval between polypectomy and FBT, a cutoff of 120 days was identified from the ROC curve. A stratified analysis showed that when FBT was performed within an interval of 120 days after polypectomy, there were higher biochemical pregnancy rates (73.2%, 45.2%; OR 3.3; P = .007) and clinical pregnancy rates (64.8%, 41.9%; OR 2.54; P = .032), when compared with intervals greater than 120 days. There were no significant differences in implantation and live birth rates. In conclusion, pregnancy rates following FBT in patients who had received prior endometrial polypectomy were comparable to pregnancy rates after FBT in patients without endometrial polyp. Subgroup analysis showed that an interval greater than 120 days between hysteroscopic polypectomy and FBT was associated with decreased pregnancy rates. Patients who wish to receive embryo transfer after polypectomy should wait no longer than 120 days.

Endometrial polyps and their insinuation in the pregnancy rates of patients undergoing ICSI-FET cycles: A retrospective cohort study

“…21 A randomized control study by Tu-Y-A et al showed a clinical pregnancy rate of 64.8% in frozen embryo transfer following polypectomy. 22 Varates et al and Shokeir et al studies also have shown a positive effect on embryo implantation after endometrial polypectomy. 9,10 Eryilmaz et al study showed IVF outcomes were unrelated to the time interval between the hysteroscopic polypectomy.…”

The effects of hysteroscopic morcellation of endometrial polyps on frozen embryo transfer outcomes

“…Another retrospective study showed that time interval between hysteroscopic polypectomy (n = 205) and embryo transfer, which included a subanalysis of euploid single FET from autologous cycles, did not impact IR, OPR, or early pregnancy loss rates [11]. A more recent retrospective study comparing first FET cycles of women with hysteroscopic polypectomy bluntly via resectoscope cutting loop without diathermy (n = 101) versus women without prior diagnosis of endometrial polyps (n = 102) showed no difference in CPR or LBR between groups if FET was performed within 120 days of polypectomy [20].…”

Benefits of antibiotics and the optimal time interval between biopsy and the next embryo transfer in patients with chronic endometritis

“…Some studies have investigated TI after hysteroscopic polypectomy, [10,16,17] intrauterine adhesions, [18] scratching for endometrial stimulation, [19] or hysteroscopic exploration without tissue biopsy. [9] Tu et al [10] retrospectively studied 102 IVF patients with endometrial polyps who underwent hysteroscopic polypectomy and found that a TI of > 4 months was associated with a decreased rate of successful pregnancy outcomes, thus recommending that these patients wait no longer than 4 months before their next ET cycle. Pereira et al [17] found that patients who underwent ET < 1, 1 to 3, and > 3 months after hysteroscopic polypectomy exhibited no differences in IR, suggesting that they could undergo ET within 1 month after hysteroscopic polypectomy However, Eryilmaz et al [16] concluded that pregnancy outcomes were unrelated to TI, as no significant difference was found in pregnancy outcome rates between patients who underwent ET < 6 months and > 6 months after hysteroscopic polypectomy in their study.…”

“…Some studies have investigated the time interval (TI) after hysteroscopic polypectomy in patients with endometrial polyps, whereas others have studied TI after hysteroscopic exploration without endometrial biopsy. [9][10][11] However, there are very few reports of TI after hysteroscopic biopsy in patients diagnosed with CE.…”