Frequency of Endometriosis in Endometrial Polyps Kim et al 46 Endometriosis occurs in 3% to 10% of women of reproductive age and in 25% to 35% of those with infertility. 1,2 It is manifested by a variety of symptoms and signs including dysmenorrhea, pelvic pain, infer- tility, irregular menstruation, increased menstrual flow, and premenstrual vaginal spotting, but as yet the exact mechanisms underlying these clinical features are not fully known. 3,4 A possible explanation for the men- strual disorders and otherwise unexplained infertility is the presence of an endometrial abnormality in the uterine cavity. Hysterosalpingographs showing endo- metrial polyps revealed an increased frequency of endometriosis. 5 In addition, when endometrial epithe- lial and stromal cells from patients with the disease are cocultured in vitro with intraperitoneal macrophages from the same patients, proliferation of endometrial epithelial and stromal cells is increased compared with those without added intraperitoneal macrophages. 6 These results suggest the possibility of high fre- quency of endometrial polyps, which could explain various symptoms of endometriosis. Moreover, it is well known that endometrial lesions such as endo- metrial polyps and submucosal myomas are etiologic factors in infertility. After these polyps are removed, pregnancy rates increase, reflecting the importance of surgical removal of endometrial lesions in women with infertility. 7 Materials and Methods We compared the frequency of endometrial polyps in 183 infertile women, of whom 92 (mean age 30.6 From the Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea (all authors); and Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital, Ilsan, Korea (Dr. YAKim). Address reprints requests to Kyung Joo Hwang, M.D., Department of Obstetrics and Gynecology, Ajou University School of Medicine, San 5, Wonchon- dong, Paldal-gu, Suwon 442-749, Korea; fax 82 31 219 5245. Accepted for publication July 24, 2002. Abstract Study Objective. To evaluate the effectiveness of hysteroscopy and the frequency of endometrial polyps in women with endometriosis. Design. Retrospective clinical study (Canadian Task Force classification II-2). Setting. Infertility unit at a university-affiliated hospital. Patients. One hundred eighty-three infertile women, 92 with endometriosis and 91 controls without the disease. Interventions. Laparoscopy and scoring of endometriosis according to the American Fertility Society classifica- tion, and confirmation of endometrial polyps by pathologic examination. Measurements and Main Results. There was no significant difference between groups with regard to age, mean duration of infertility, and frequency of primary or secondary infertility. Endometrial polyps were found in 43 women (46.7%) with endometriosis and in 15 controls (16.5%, p = 0.0000). Their frequency did not differ significantly according to stage of endometriosis. Conclusion. We strongly recommend hysteroscopy if endometriosis is detected in a woman undergoing evalua- tion for infertility, even if hysterosalpingography and transvaginal ultrasonography do not suggest endometrial polyps. (J Am Assoc Gynecol Laparosc 10(1):46–48, 2003) High Frequency of Endometrial Polyps in Endometriosis Mi Ran Kim, M.D., Young Ah Kim, M.D., Mi Yeong Jo, M.D., Kyung Joo Hwang, M.D., and Hee Sug Ryu, M.D. Reprinted from the JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS, February 2003, Vol. 10 No. 1 © 2003 The American Association of Gynecologic Laparoscopists. All rights reserved. This work may not be reproduced in any form or by any means without written permission from the AAGL. This includes but is not limited to, the posting of electronic files on the Internet, transferring electronic files to other persons, distributing printed output, and photocopying. To order multiple reprints of an individual article or request authorization to make photocopies, please contact the AAGL.