Uterine polyps may be discovered during preparation for IVF when the uterus is evaluated by hysterosalpingogram or during routine vaginal ultrasound monitoring.  The question of whether these polyps should be surgically removed prior to in-vitro fertilization treatment has been controversial.  Many reproductive specialists have recommended removal based on data suggesting improved implantation rates following surgical polypectomy.  Several papers have suggested removing only polyps which are greater than 1cm in diameter.  A recent Turkish paper (in press) suggests that removal of polyps measuring less than 1.5cm offers no advantage in terms of pregnancy or live birth rates.  

There have been several publications in recent years suggesting that minor trauma to the uterine lining in the menstrual cycle preceding an IVF treatment cycle results in a significant improvement in embryo implantation.  A recent study suggests that obtaining a biopsy from a precise location within the uterine cavity during the IVF treatment cycle significantly improved the prospect of embryo implantation. This study is the first to indicate that location and timing of the biopsy may impact favorably the chances for pregnancy in patients who have had repeated failure of healthy appearing embryos to implant.