Polycystic ovarian syndrome – association and risk factors between endometrial polyp and infertility. A retrospective study

Introduction
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder and is one of the most common causes of infertility. The study aimed to investigate the association between endometrial polyp and infertility in PCOS in a high-incidence region such as the Middle East. Also, to identify the most common risk factors for endometrial polyp(s) in PCOS patients with infertility.

Material and methods
We conducted a retrospective cohort study on a total of 250 patients with a confirmed diagnosis of a PCOS. Eighty patients out of the 250 were finally included in the study after a high suspicion of endometrial polyp by 2-D transvaginal ultrasound at the early follicular phase, and they underwent an office hysteroscopy at the late follicular phase after proper counselling.

Results
Out of 80 patients enrolled in the study, 62 were confirmed to have endometrial polyp(s) by office hysteroscopy; 6 patients had a polypoid endometrium, 10 patients had an isolated increased endometrial thickness, and 2 patients had a small submucosal fibroid (less than 1.5 cm). The most observed co-factors in patients with PCOS and endometrial polyps are obesity, followed by oligomenorrhoea and amenorrhoea (hyperoestrogenic status).

Conclusions
Our study found that there is an association between PCOS with infertility and endometrial polyp(s). The most common associated factor is obesity, followed by oligomenorrhoea and amenorrhoea (hyperoestrogenic status). We hope that our study will raise global awareness about the unwanted effects of obesity in PCOS on general and reproductive health. A large study in the future is needed to confirm our results.