[18] Larger sized polyps measuring greater than 1.5 cm in length is less likely to resolve spontaneously, and polypectomy could be considered in symptomatic patients. Endometrial polyps can have a negative impact on the quality of life and mental health in patients who have a poor understanding of the disease. They are the most common colon polyp, estimated to comprise 75 - 90% of colon polyps, typically 1 - 5 mm in greatest dimension, rarely 1 cm or greater They usually are found during endoscopies in patients starting in their 50s but may be found in much younger patients and the incidence increases with age Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. 2012 Jan-Feb;     [PubMed PMID: 22196255], Lieng M,Istre O,Sandvik L,Qvigstad E, Prevalence, 1-year regression rate, and clinical significance of asymptomatic endometrial polyps: cross-sectional study. d) Saline infusion sonography is less painful than outpatient hysteroscopy . Definition: Relatively indolent tumors that arise in background of endometrial hyperplasia.. Tissue polyps can crop up during this regeneration. My students have encouraged me to consolidate all my knowledge into one resource. Familial adenomatous polyposis (FAP) is a rare, inherited condition caused by a defect in the adenomatous polyposis coli (APC) gene. Explain the importance of collaboration and communication among the interprofessional team to ensure the appropriate selection of candidates for surgical management of endometrial polyps. To begin with, let’s define both uterine polyps and fibroids — what are they? only in female; most commonly in those 25-29 years of age ; location . [21], After hysteroscopic polypectomy, the collected specimens should be submitted to pathology for evaluation. One in four reproductive-aged women with abnormal bleeding will have endometrial polyps within the cavity. Ann Surg Oncol . Malignancy in an endometrial polyp is related to a patient’s age and menopausal status. Diagnosis. [2][3][4][5] Endometrial abnormalities, including the development of polyps, are associated with chronic tamoxifen therapy and occurs in 20% to 35% of females. [ [Micrograph showing nucleated red blood cells (bottom left of image), one of the elements necessary to call extramedullary hematopoiesis, in an endometrial polyp. Quality of life and future fertility is also impacted by the presence of endometrial polyps. Benign collection of endometrial tissue in the uterine wall that extend into the uterine cavity; Also known as uterine polyps; Ranges from a few millimeters to several centimeters in diameter; Pathogenesis grow in response to estrogen; Epidemiology in … Blind endometrial biopsy will reliably detect polyp tissue . The most commonly reported patterns include menorrhagia and intermenstrual spotting. Premenopausal females are less likely to have malignant endometrial polyps compared to postmenopausal females. 2011 Aug;     [PubMed PMID: 21804459], Runowicz CD,Costantino JP,Wickerham DL,Cecchini RS,Cronin WM,Ford LG,Vogel VG,Wolmark N, Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). A majority of polyps have benign pathology however, patients should also be counseled on the possible risk of malignancy. Hysterectomy is associated with significantly greater risk to the patient and cost and should only be contemplated after extensive patient counseling.[16]. 2,000 terms. Uterine polyps or Endometrial Polyps are overgrowths that occur from the inner lining of the uterus. 34 terms. True or false? Uterine Polyps. Uterine polyps can develop in both premeno… Ashley_Grimm. A biopsy may also be performed in women younger than 45 years if they have risk factors for endometrial cancer or are felt to be at increased risk for an infection of the endometrium. - Additional sonographic appearance of endometrial polyps may include diffuse endometrial thickening due to a large endometrial polyp. USMLE 1 Endometrial Neoplasms. Uterine, or endometrial polyps, are growths of endometrial glands and stroma that protrude into the uterine cavity - and they’re usually benign. Try now for free! Endometrial polyps vary in size from few millimeters to several centimeters in diameter. Other histological findings include carcinomatous, atrophic, or hyperplastic.[1]. European journal of obstetrics, gynecology, and reproductive biology. cancers can be divided into two types based on histological characteristics; type I cancers account for 80% of all. July 16, 2018 at 1:00 pm. Learn and reinforce your understanding of Uterine disorders: Pathology review through video. This endocrinology course covers all essentials: anatomy of the normal uterus , anovulatory cycle , endometrial polyp . Learn and reinforce your understanding of Uterine disorders: Pathology review through video. Patients should be educated on the possibility of recurrence and modifiable factors to decrease these risks. Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. 1995 Apr 1;     [PubMed PMID: 7882366], Xuebing P,TinChiu L,Enlan X,Jing L,Xiaowu H, Is endometrial polyp formation associated with increased expression of vascular endothelial growth factor and transforming growth factor-beta1? this is what normal Uterus layers look like. 2005 Jun;     [PubMed PMID: 15760959], Sun Y,Zhang J,Bai W, Higher Prevalence of Endometrial Polyps in Patients with Fallopian Tube Obstruction: A Case-control Study. Contraindications include active uterine or cervical infection and pregnancy. Cancer research. American journal of obstetrics and gynecology. Endometrial polyps may be diagnosed at all ages; however, peak incidence occurs between the age of 40 to 49 years old. [7] Malignancy in an endometrial polyp is related to a patient’s age and menopausal status. Review the risk factors for developing an endometrial polyp. Journal of minimally invasive gynecology. Recurrence risks should be discussed, and appropriate candidates may benefit from endometrial ablation and levonorgestrel intrauterine device to decrease these risks. Maturitas. But for 25 to 30 percent of people, the genetic mutation occurs spontaneously.FAP causes extra tissue (polyps) to form in your large intestine (colon) and rectum. 1994 Jul;     [PubMed PMID: 7933016], Hassa H,Tekin B,Senses T,Kaya M,Karatas A, Are the site, diameter, and number of endometrial polyps related with symptomatology? A prospective, randomized controlled trial showed that hysteroscopic polypectomy before intrauterine insemination is an effective measure and improved pregnancy rates. Hormone Binding Proteins Next up, there’s A for adenomyosis. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia.With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. [19] Treatment after hysteroscopic polypectomy is effective with low recurrence in patients who initially presented with fewer number of polyps. [6] Furthermore, hormone replacement therapy for menopausal symptoms may also be associated with the formation of endometrial polyps with reported symptoms of irregular bleeding and thickened endometrium on ultrasound.[13]. Tamoxifen, often used in the treatment of breast cancer, has agonistic or antagonistic effects on tissue containing estrogen receptors. Complications associated with hysteroscopic polypectomy are rare, and the risk of intrauterine adhesion is low.[22]. Created by. A 60-year-old G0 female was found on outpatient endometrial biopsy to have abnormal proliferation of stromal and glandular endometrial elements. Benign polyps have been found in 20% of cases with a diagnosis of endometrial carcinoma. Endometrial polyps refer to overgrowths of endometrial glands and stroma within the uterine cavity. 03. Findings on ultrasound may appear nonspecific with diffuse or localized, echogenic endometrial thickening. cause of endometrial polyp. Obstetrics and gynecology. According to one definition, when endometrial glands show a confluent pattern occupying at least 2x2 mm focus, the diagnosis of adenocarcinoma can be made. ... - Tamoxifen is agonist on endometrial tissue (risk of cancer) while Raloxifen is antagonist on endometrial tissue (no risk of cancer). In principle, any anatomic lesion in premenopausal women (e.g. 2009 Jul-Aug;     [PubMed PMID: 19573823], de Azevedo JM,de Azevedo LM,Freitas F,Wender MC, Endometrial polyps: when to resect? A majority of polyps are benign; however, malignant transformation can occur in 0 to 13%. [14] In patients with symptoms of postmenopausal bleeding, endometrial thickness of less than 4 mm is associated with an atrophic endometrium. d) Saline infusion sonography is less painful than outpatient hysteroscopy . Blind endometrial biopsy will reliably detect polyp tissue . Polyps are better visualized with fluid outlining the mass. International journal of surgery (London, England). PLAY. A majority of polyps will be composed of the endometrium that differs from the surrounding endometrium and does not respond to cyclic hormonal changes. 2019 Jul - Aug;     [PubMed PMID: 30273685], Elias RT,Pereira N,Karipcin FS,Rosenwaks Z,Spandorfer SD, Impact of newly diagnosed endometrial polyps during controlled ovarian hyperstimulation on in vitro fertilization outcomes. For any patient with abnormal uterine bleeding, it is important to identify the underlying cause, severity, any associated symptoms, and comorbidities. Smaller foci are labeled "complex endometrial hyperplasia". [16] Recurrence rates are further decreased if hysteroscopic polypectomy is combined with endometrial ablation or insertion of a levonorgestrel-releasing intrauterine device. Androgen Insensitivity Syndrome / Testicular Feminization, Preeclampsia / Eclampsia / HELLP Syndrome, Mammary Duct Ectasia / Plasma Cell Mastitis, Selective Estrogen Receptor Modulators (SERMs), Ranges from a few millimeters to several centimeters in diameter, in women going through or have completed menopause, however, endometrial hyperplasia or carcinomas may appear as polyps, If not suspicious for cancer, observation with good follow-up. Conflicting data is available on the relationship between endometrial polyps and the risk of infertility. Another method to evaluate the endometrial cavity is with saline-infusion sonography (SIS). A pelvic exam, ultrasound or laparoscopy are used to diagnose endometriosis. The timing of hysteroscopic polypectomy is unclear for asymptomatic and low-risk patients. Laboratory studies are also considered in the evaluation of abnormal uterine bleeding. Tissue sampling should be considered due to the risk of malignancy associated with endometrial polyps. [13] The location of the polyp, number, and diameter does not correlate with the reported symptoms.[15]. She has never been pregnant before. Corpus cancer is the most frequently occurring female genital cancer. Education should focus on the etiology and the management of abnormal uterine bleeding. [24] In contrast, a retrospective review of patients who received in vitro fertilization (IVF) with known polyps during IVF cycles found no difference in pregnancy rates, miscarriage rates, or live birth rates. Patients with endometrial polyps may be asymptomatic, or the most common symptom is abnormal uterine bleeding. This modality involves instilling about 5 to 30 mL of warmed saline into the uterine cavity using a thin catheter during the proliferative phase of the menstrual cycle. 2010 Nov;     [PubMed PMID: 20966706], Elfayomy AK,Soliman BS, Risk Factors Associated with the Malignant Changes of Symptomatic and Asymptomatic Endometrial Polyps in Premenopausal Women. abnormal uterine bleeding. Uterine disorders: Pathology review - Osmosis is an efficient, enjoyable, and social way to learn. She undergoes a transvaginal ultrasound, which reveals several small masses in the uterine cavity. More importantly, these methods will not provide tissue diagnosis. ... WHAT IS A CERVICAL POLYP? Endometrioid tumors tend to have a favorable prognosis and typically present at an early stage with abnormal uterine bleeding. [23] Also, the prevalence of endometrial polyps is significantly higher in infertile patients with Fallopian tube obstruction than in patients with Fallopian tube patency. All healthcare professionals should counsel the patient on the benefits, risks, alternatives, and outcomes of the procedure. In addition, SIS provides better differentiation between submucosal fibroids and endometrial polyps by visualizing the location in relation to the endometrial layer. 1996 Nov;     [PubMed PMID: 9132309], Kupfer MC,Schiller VL,Hansen GC,Tessler FN, Transvaginal sonographic evaluation of endometrial polyps. However, endometrial polyps are associated with endometrial hyperplasia; therefore, unopposed estrogen is considered to be a risk factor. family history; early menarche Medical management with hormonal therapy has limited support in the literature and cannot be recommended at this time. [17] Conservative management includes periodic assessment of polyp growth with ultrasound. Free Questions and Answers for All Medical Students all over the World. My name is Dr. Danial Tahir. They are more frequent in females who are on tamoxifen therapy, a medication sometimes given for breast cancer . 2015 May-Jun;     [PubMed PMID: 25580003]. Specialized surgical nurses will be responsible for preparing the patient before and after the procedure, intraoperative positioning, and arranging the correct surgical supplies. Corpus cancer is the most frequently occurring female genital cancer. These factors and how they affect endometrial cancer risk are covered in more detail below. Don't study it, Osmose it. endometrial polyp presentation? Debris from the endometrial implants remains in the body, potentially causing other problems, including pelvic adhesions or infertility. endometrial. Most people inherit the gene from a parent. Don't study it, Osmose it. Sign up for an account today! Get help and assistance with your residency application. Smaller foci are labeled "complex endometrial hyperplasia". According to one definition, when endometrial glands show a confluent pattern occupying at least 2x2 mm focus, the diagnosis of adenocarcinoma can be made. Patients should be counseled on the disease pathology keeping in mind that terms like “lesion” or “neoplasm” may cause excessive concern for the patient. [1] Endometrial polyps are primarily covered by epithelial tissue superficially and contain a largely vascular core. a nonmalignant condition where the endometrial gla nds and stroma are located outside of the uterus; Epidemiology . Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 7. * Re: Endometrial polyp #27975 - 03/11/04 17:30 : Rav The important points here are 1)the woman has developed post menopausal bleeding and 2)the woman has several condn's making her a poor risk for major surgery like hysterectomy.The endometrial biopsy is inconclusive (with atypical cells that are difficult to grade. If you dread your period because you hav… It is caused by excess estrogen unopposed by progesterone. [1] Other associated symptoms include abdominal pain, pelvic pain, or infertility. c) 3D ultrasound is more accurate than saline infusion sonography . 2018;     [PubMed PMID: 29606892], Uglietti A,Mazzei C,Deminico N,Somigliana E,Vercellini P,Fedele L, Endometrial polyps detected at ultrasound and rate of malignancy. )Hence I will have to go with option C which should definitely be … Polyps can also occur in the upper gastrointestinal tract, especially the upper part of your small intestine (duodenum). 2016 Mar;     [PubMed PMID: 26305029], Cravello L,Stolla V,Bretelle F,Roger V,Blanc B, Hysteroscopic resection of endometrial polyps: a study of 195 cases. 2014 Apr;     [PubMed PMID: 24091484], Mourits MJ,De Vries EG,Willemse PH,Ten Hoor KA,Hollema H,Van der Zee AG, Tamoxifen treatment and gynecologic side effects: a review. Treatment of the uterine polyps includes medications and surgical removal. Endometrial. A general physical exam should be performed along with a bimanual exam and sterile speculum exam during the clinic visits. Uterine polyps or Endometrial Polyps are overgrowths that occur from the inner lining of the uterus. A polyp will be seen arising from the endometrial layer, and a submucosal fibroid will be visualized under this layer. Polyps may be found as a single lesion or multiple lesions filling the entire endometrial cavity. polyp, nodule, lush irregularity) and any worrisome thickening of the endometrium in postmenopausal women requires sampling Historically, an endometrial thickness of 10 mm or more has been considered the threshold for endometrial cancer in postmenopausal women 3. follicle growth, endometrial proliferation, inc myometrial excitability 4. inc transport proteins, SHBH 5. inc HDL, dec LDL 6. upregulate estrogen, LH, FSH, progesterone receptors 7. feedback inhibition of FSH, LH, then LH surge 8. stimulation of prolactin secretion Journal of obstetrics and gynaecology of India. Cancer genetics and cytogenetics. Uterine polyps may recur even after treatment, hence regular follow-up is recommended. * Endometrial polyp #7187 - 03/11/04 10:07 : bill Q) A 75-year-old woman comes to the physician because of irregular vaginal bleeding. Polyps may be associated with underlying endometrial pathology; therefore, both the polyp and the surrounding endometrium should be histologically evaluated. This activity reviews the evaluation and management of endometrial polyps and explains the role of the interprofessional team in evaluating and treating patients with this condition. [16] In patients with tamoxifen-associated polyps, levonorgestrel intrauterine device (IUD) has been shown to decrease polyp formation and may be considered as part of the management plan. 2006 Mar;     [PubMed PMID: 16522403], AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. Uterine polyps tend to grow in round or oval shapes upon the wall of the uterus. If the surrounding endometrium shows hyperplasia, it should be treated accordingly. American journal of obstetrics and gynecology. For patients with anemia secondary to abnormal uterine bleeding, consider daily iron supplementation. However, endometrial polyps are associated with endometrial hyperplasia; therefore, unopposed estrogen is considered to be a risk factor. The exact cause of uterine polyps is unknown. Tamoxifen works as an anti-cancer agent on breast tissue; however, it acts as a carcinogenic agent on endometrial tissue. In this specific case, characterization of a hypoechoic halo surrounding the polyp or even the bright edges sign may improve the accuracy to diagnosis an endometrial polyp. e) Hysteroscopy has the highest accuracy for the diagnosis of endometrial polyps . More than 500 figures to help you prepare well for your USMLE Step 1 exam. Diagrams. Test. Endometrioid carcinoma is the most common histologic type of endometrial carcinoma and of uterine malignancy overall. Definition: Relatively indolent tumors that arise in background of endometrial hyperplasia.. To obtain tissue diagnosis, an endometrial biopsy, dilation, and curettage (D&C) or hysteroscopic polypectomy must be completed. 2011 Dec;     [PubMed PMID: 21872200], Bakour SH,Khan KS,Gupta JK, The risk of premalignant and malignant pathology in endometrial polyps. However, increased endometrial thickness greater than 4 mm is related to endometrial pathology, including polyps. Polyps may be found as a single lesion or multiple lesions filling the entire endometrial cavity. Exam of chest shows: Breath sounds--decreased in R lung base, normal in L lung base [11], Polyps are endometrial epithelial proliferations comprised of vascular, glandular, fibromuscular, and connective tissues. ... Usmle Step 1 First Aid. She has been menopausal for the past 25 years, but has noted on-and-off spotting for the past 2 years, which she finds intolerable. incidence. Wethington SL, Herzog TJ, Burke WM, et al. I'm a graduate of Ayub Medical College, Abbottabad Pakistan. A pelvic exam, ultrasound or laparoscopy are used to diagnose endometriosis. Professional … USMLE Q Bank; ... Endometrial cancer b. Atrophic vaginitis c. Endometrial polyp d. Cervical cancer e. Cervical ectropion. Approximately 47,100 cases of corpus cancer were predicted to occur in the United States in 2012, making it the fourth most common cancer among women; of these women, approximately 8,000 will die from the disease. https://www.merckmanuals.com/.../miscellaneous-gynecologic-disorders/ Hormone Sensitive Lipase Vs Lipoprotein Lipase Usmle Diagnosis Tests if this occurs for more than 3 months. Whether you or someone you love has cancer, knowing what to expect can help you cope. Uterine polyps may recur even after treatment, hence regular follow-up is recommended. Management of endometrial hyperplasia confined to an endometrial polyp: The uterine polyp should be removed completely, and the rest of the endometrium should be sampled. 04. 2. meningioma. Archives of gynecology and obstetrics. SIS provides a better evaluation of the adnexa and cornua compared to transvaginal ultrasound. The definite etiology of endometrial polyps is unknown. It is a non-cancerous growth. 1993 Jul 1;     [PubMed PMID: 8330280], Dal Cin P,Vanni R,Marras S,Moerman P,Kools P,Andria M,Valdes E,Deprest J,Van de Ven W,Van den Berghe H, Four cytogenetic subgroups can be identified in endometrial polyps. Incidental endometrial polyps may regress spontaneously if left untreated. 以上来源于:Wikipedia. The exact cause of uterine polyps is unknown. Medical science monitor : international medical journal of experimental and clinical research. Other mechanisms that have been associated with the development of … Journal of minimally invasive gynecology. International journal of women's health. Learn. Endometrial polyps are localized overgrowths of the endometrial glands and stroma that protrudes out of the endometrium. Obtaining a comprehensive medical and surgical history is crucial to exclude other causes of abnormal uterine bleeding. The Journal of the American Association of Gynecologic Laparoscopists. Free Questions and Answers for All Medical Students all over the World. A prolapsed polyp may contain areas of squamous metaplasia, infection or ulceration. [25] Currently, the expert recommendation is the removal of endometrial polyps prior to in-vitro fertilization. She denies any history of STIs. a hyperplastic polyp b inflammatory pseudopolyp (wrong) c juvenile polyp d peutz jeghers syndrome e tubular adenoma 2. 2015 May;     [PubMed PMID: 26085741], Kolhe S, Management of abnormal uterine bleeding - focus on ambulatory hysteroscopy. PloS one. In one trial, 29% of endometrial polyps resolved spontaneously after 1 year in premenopausal patients. From Outside; SerosaMyometriumEndometrium POLYP;small smooth muscle mass Inter menstrual SpottingNo Big Deal! Polyps may be found as a single lesion or multiple lesions filling the entire endometrial cavity. From basic information about cancer and its causes to in-depth information on specific cancer types – including risk factors, early detection, diagnosis, and treatment options – you’ll find it here. Outline the typical presentation of a patient with endometrial polyps. It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Usmle Step 2 Cs - Vaginal Bleeding. The patient reports that her last menstrual period was 1 week ago and she soaked through 1 tampon every 1-2 hours during that time. incidence. Studies should include a urine pregnancy test, a complete blood count, and a coagulation panel to rule out anemia and coagulopathy. Endometrial polyps refer to overgrowths of endometrial glands and stroma within the uterine cavity. 797 talking about this. Endometrioid tumors tend to have a favorable prognosis and typically present at an early stage with abnormal uterine bleeding. Repeated USMLE Questions. European journal of obstetrics, gynecology, and reproductive biology. incidence … July 16, 2018 at 1:00 pm. Steroid Hormone Receptors. polyp <10 mm. MEDtube.net - social eLearning platform for MDs and med students. Endometrial hyperplasia is a condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus.. Other methods of evaluation include hysterosalpingograms or hysteroscopy. On follow up of specimen pathology, polyps may have evidence of malignancy, and referral to gynecology oncology is recommended for further management. Feel free to get in touch with us and send a message. 1. abnormal uterine bleeding - (stretching of uterine wall) 2. infertility - (bc stretching of uterine wall - too thin to implant) 3. pelvic mass - from leiomyoma fibroids. e) Hysteroscopy has the highest accuracy for the diagnosis of endometrial polyps . Quizlet Live. Title: Usmle step 2 second edition 072208 part 2, Author: Surgisphere, Name: Usmle step 2 second edition 072208 part 2, Length: 218 pages, Page: 116, Published: 2013-11-12 Issuu company logo Issuu Mild or simple hyperplasia, the most common type, has a very small risk of becoming cancer. Treatment of the uterine polyps includes medications and surgical removal. In cases of surgical management, anesthesia consult should be considered for high-risk patients. The prevalence of malignant endometrial polyps in the symptomatic postmenopausal female is 4.47% compared with 1.51% in an asymptomatic postmenopausal female. Acta obstetricia et gynecologica Scandinavica. Afterwards, a histologic examination of the polyp can confirm that the polyp is benign. Terms in this set (43) what is asherman syndrome. In the absence of hyperplasia in the surrounding endometrium, it is considered curative. H&E stain. Describe the typical imaging findings associated with endometrial polyps. Endometrial thickness is a commonly measured parameter on routine gynecological ultrasound and MRI. STUDY. [1][19] The recurrence rate in histologically confirmed polyps is approximately 2.5% to 3.7%. Endometrial thickness is a commonly measured parameter on routine gynecological ultrasound and MRI. Get the ultimate guide for understanding uterine and fallopian tube disease! A pedunculated endometrial polyp may be visualized from the external os. Pathology shows an increased gland … Endometrial biopsy — An endometrial biopsy is often performed in women age 45 or older to rule out endometrial cancer or abnormal endometrial growths. Emphasis should be placed on communication and collaboration among team members to deliver safe and patient-centered care. 2016 Jul;     [PubMed PMID: 27180151], Deans R,Abbott J, Review of intrauterine adhesions. Tamoxifen causes endometrial changes, including polyp formation, hyperplasia, and frank invasive carcinoma. [6], A majority of polyps are benign; however, malignant transformation can occur in 0 to 13%. Copyright © 2021 Lineage Medical, Inc. All rights reserved. USMLE - Endocrine Pharm. Uterine disorders: Pathology review - Osmosis is an efficient, enjoyable, and social way to learn. Adenomyosis is a specific form of endometriosis, in which endometrial tissue develops ectopically in the myometrium - or the muscular layer of the … 2010 Sep-Oct;     [PubMed PMID: 20656564], Pérez-Medina T,Bajo-Arenas J,Salazar F,Redondo T,Sanfrutos L,Alvarez P,Engels V, Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. c) 3D ultrasound is more accurate than saline infusion sonography . Discussion of malignancy carries a potentially harmful risk to the mental well-being of patients. TRIAL VIDEO - Buy membership to unlock complete course. Endometrial abnormalities, including the development of polyps, are associated with chronic tamoxifen therapy and occurs in 20% to 35% of females.