Today we want to present a case of a patient who came to Creafam Veracruz for primary infertility. As part of her evaluations prior to carrying out IVF fertility treatment, we performed a vaginal pelvic ultrasound where we had the opportunity to observe signs of endometrial pathology.
Evaluations prior to in vitro treatment are very important since there may be other associated pathologies that the patient is unaware of and that may eventually affect the prognosis of the result.
In this case, our patient was a 39-year-old patient, with more than five years of primary infertility. She had some very brief basic studies, very normal, and then we started the study plan; We indicate a semen study, hormonal tests, blood tests and as part of this, we perform a pelvic ultrasound vaginally. When an ultrasound is performed, the interpretation of the images will depend a lot on the moment of the cycle in which the patient is, particularly ultrasounds from the first half of the cycle, that is, before ovulation, can provide us with a lot of information about the endometrium. As you will see below, this patient presented a finding that was important to resolve since it could affect the prognosis of the future treatment that we are going to perform, which in her case will be in vitro fertilization. Once the diagnosis of endometrial polyps has been made by ultrasound, it is important to offer the patient alternatives.
There are doctors who propose performing uterine curettage and with that they can extract it, in our opinion in a very bloody attitude for the endometrium, especially in patients who want fertility, since we can cause damage to the cavity that worsens the prognosis. The best alternative to remove endometrial polyps is through hysteroscopy, an endoscopic procedure specifically designed to attend to the uterine cavity and that allows us to observe all the characteristics of the cervix, the cavity, the origin of the tubal ostia and a very precise evaluation. of the endometrium and the space that the patient has in her uterine cavity.