Polycystic Ovarian Syndrome and Increased BMI Associated with Endometrial Polyps, Study Shows

   Both polycystic ovarian syndrome (PCOS) and increased BMI, known conditions of estrogen excess, were associated with endometrial polyps in research presented at the American College of Obstetricians and Gynecologists’ 59th Annual Clinical Meeting in Washington, D.C.

   Realizing that the etiology of endometrial polyps is elusive, researchers at Mid-Iowa Fertility in Clive designed a study to assess a possible association between the polyps and PCOS. They performed a retrospective review of all patients who underwent hysteroscopy (with or without laparoscopy) between March 2006 and February 2010. They noted hysteroscopy findings, age, gravidity, parity, BMI, tobacco usage, and past medical and reproductive histories (including other infertility diagnoses).

   Heather M. Said, DO, and Brian  C. Cooper, MD, identified a total of 136 patients with and 93 patients without endometrial polyps; PCOS was present in 32/136 (24%) of polyp patients and 8/93 (9%) of those without polyps (P=0.006). Gravidity in patients with endometrial polyps and patients without endometrial polyps was 0.91 and 1.47, respectively (P>=0.009). Patients with endometrial polyps were slightly older than the control group (34 vs 32, P=0.03). BMI was significantly increased in the endometrial polyp group (29.5 vs 27.0, P=0.01). There was no significant difference in smoking status, parity, and presence of endometriosis between the two groups.

   As noted, both PCOS and increased BMI were associated with the presence of endometrial polyps. Patients with polyps had a lower gravidity than controls, a condition that may be explained by more frequent anovulation.  According to Drs. Said and Cooper, "Although a causal relationship has not been established, this study supports the concept that conditions of estrogen excess, specifically polycystic ovarian syndrome and increased BMI, lead to an increased risk for the development of endometrial polyps."