Fertility researchers in the UK are investigating whether removing smaller fibroids and endometrial polyps will boost the chances of successful pregnancy and live birth rates in women undergoing treatments for infertility and recurrent miscarriages.
The new multi-centre trial, funded by the NIHR and led by researchers from Sheffield Teaching Hospitals NHS Foundation Trust (FT), will run across 30 gynaecology and fertility centres in the UK, and is the first to assess if removing fibroids and endometrial polyps less than 3cm can improve women’s chances of having a baby.
Fibroids and endometrial polyps are very common, especially in reproductive-age women. While these non-cancerous tumours have long been linked to fertility issues, there is limited clinical evidence to show that their removal increases live birth rates and improves fertility.
The findings of the £1.8 million HELP Fertility? trial will help to determine whether smaller fibroids and endometrial polyps should be removed during fertility treatment.
“Hysteroscopy is an optional additional treatment offered to women with smaller fibroids and endometrial polyps as part of their fertility treatment. Yet there is little clinical evidence to support its use in those undergoing IVF or assisted conception,” said Mr Mostafa Metwally, chief investigator and consultant gynaecologist and sub-specialist in Reproductive Medicine and Surgery at Sheffield Teaching Hospitals NHS FT.
“This gold standard study will provide women with much-needed answers as to its benefit, enabling them to make an informed decision as to whether they should delay fertility treatment to have these smaller fibroids and polyps removed or leave them in place. As well as demonstrating the clear benefit of hysteroscopy as an optional add-on fertility treatment, we will also assess if there is a potential negative impact on women’s fertility of hysteroscopy, which some women find invasive and painful.”
Around 20-40% of women with unexplained infertility are found to have fibroids and around 15-20% endometrial polyps.
Initial findings of the study are expected to be published in the summer of 2025.