Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute For Reproductive Biomedicine, ACECR, Tehran, Iran
Endometrial abnormalities such as polyps and fibroma are responsible for infertility in women. The prevalence of endometrial polyps and fibroma is 10-40% and 20%, respectively. Recent studies have shown that the prevalence of coexisting endometrial polyp and fibroma is about 20.1%. Due to the high prevalence of coexisting polyp and fibroma, accurate and precise assessment of endometrium should be considered if fibroma or polyp is detected in the uterus. In case that sub mucosal or intramural fibroma results in endometrial distortion, more attention should be considered. Polyp is seen next to the fibromas or on the opposite side of the endometrium.
Figure 1 demonstrates the transverse section of the uterus. A 30 Mm intramural fibroma is seen in the left side of the uterus and a 10 Mm polyp is located on the endometrium, just beside the fibroma.
Figure 2 shows the sagittal view of the uterus. an intramural fibroma which has distorted endometrium is seen. A 6 Mm polyp is on the opposite side of fibroma.
Figure 3 a depicts a transvers section of the uterus and a 44 Mm intramural fibroma; and a 11 Mm polyp in the sagittal view of the uterus is seen in figure 3B.
The diagram shows the different sites of abnormalities in the endometrium. The mechanical effect of fibroma leads to distortion of the uterus and it may result in formation of polyps. The main hormone related to the both anomalies is estrogen hormone. Hormones and their receptors in the specific sites would account for coexisting endometrial polyp and fibroma.
Transvaginal sonography, saline infusion sonohysterography, and hysteroscopy are the beast modalities for diagnosis of these anomalies. Hysteroscopic resection should be considered for treatment of polyps; However, hysterectomy is the definitive solution.