Effect of hysteroscopic cold -knife resection combined with dydrogesterone therapy on natural conception outcomes in women with endometrial polyps.

Abstract

Introduction: This study was conducted to explore the impact of hysteroscopic cold-knife resection (HCKR) combined with dydrogesterone on natural conception in patients with endometrial polyps (EPs).

Aim: We aimed to assess the clinical efficacy of HCKR combined with dydrogesterone in patients with EPs, focusing particularly on reproductive outcomes and natural conception rates.

Materials and methods: A total of 110 patients with EPs were categorized into 2 groups: the cold-knife group, which underwent HCKR with dydrogesterone, and the control group, which received curettage with dydrogesterone. The comparisons included baseline data, surgical indicators (operative time, intraoperative bleeding, and length of hospital stay), postoperative complications, menstrual blood loss score (as per the Pictorial Blood Assessment Chart [PBAC]), endometrial thickness, postoperative fertility outcomes, including time to ovulation recovery and 12-month natural pregnancy rate, female sexual function (as measure via the Female Sexual Function Index [FSFI]) scores (desire, arousal, lubrication, orgasm, satisfaction, and pain), and sex hormone levels pre- and 1 month post-treatment.

Results: Both groups had similar baseline characteristics. The cold-knife group demonstrated shorter operative time, reduced intraoperative blood loss, shorter hospital stay, lower postoperative complication rates, reduced PBAC scores, thinner endometrial thickness, and better fertility outcomes. Both groups showed improved FSFI scores and decreased levels of estradiol, follicle-stimulating hormone, and luteinizing hormone post-treatment, with no significant intergroup differences in hormonal parameters.

Conclusions: Hysteroscopic cold-knife resection combined with dydrogesterone is effective for treating EPs, improving surgical safety, recovery, and fertility outcomes.