Polyps, Fibroids, and Adenomyosis — Operate or Proceed?

What It Is

Polyps, fibroids, and adenomyosis are structural changes in the uterus that can interfere with implantation. Not every finding requires surgery — but in some cases, removing them improves pregnancy odds. This guide explains:

• When surgery is recommended vs. when you can safely proceed.
• How each condition affects implantation and miscarriage risk.
• What choices change outcomes, budgets, and timelines.

Who It Helps

This guidance is most relevant for :

• Patients with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL).
• Those whose ultrasound, MRI, or hysteroscopy revealed uterine abnormalities.
• Intended parents weighing whether to pause for surgery or move forward with transfer.

Step-by-Step

1. Diagnosis → Imaging (ultrasound, MRI, hysteroscopy) to confirm size and location.
2. Impact assessment → Ask: Does this lesion distort the cavity or blood flow?
3. Decision checkpoint → Small, asymptomatic lesions may not need removal.
4. Treatment → Outpatient hysteroscopy, laparoscopy, or medication if needed.
5. Recovery & timing → Healing window (2–3 months) before embryo transfer.

Pros & Cons

Pros of surgery

• Restores normal uterine environment.
• Reduces miscarriage risk.
• Often improves implantation odds for RIF/RPL patients.

Cons / trade-offs

• Delays transfer by 1–3 months.
• Surgical and anesthesia risks (low but real).
• Added cost (often $2,000–$6,000, depending on scope and insurance).
• Not all lesions actually impair outcomes.

Costs & Logistics

• Diagnostics (ultrasound, hysteroscopy, MRI): $300–$1,500.
• Surgical removal (polyps/fibroids): $2,000–$6,000 (insurance coverage varies).
• Adenomyosis treatments (GnRH, surgery, or both): $1,500–$5,000.
• Insurance pre-authorizations are often needed; budget planning helps avoid delays.

What Improves Outcomes

• Removing polyps or submucosal fibroids that distort the uterine cavity.
• Treating adenomyosis with medical suppression before transfer.
• Careful timing — ensuring full recovery before embryo transfer.
• Using checklists to avoid unnecessary “add-on” procedures.

Case Study

A 38-year-old with three failed transfers was found to have a 2.5 cm submucosal fibroid. After a hysteroscopic removal and a 2-month recovery, her next transfer succeeded.
Key insight: Surgery delayed transfer but materially improved odds.

Mistakes to Avoid

• Removing very small, harmless fibroids that don’t distort the cavity.
• Ignoring adenomyosis when miscarriage risk is high.
• Rushing into transfer too soon after surgery.
• Skipping a full uterine cavity evaluation before expensive add-ons.
• Overlooking budget, insurance, and healing timelines.

FAQs

Q. Do all fibroids or polyps need removal before IVF?

Ans : No. Only those that distort the uterine cavity or clearly impact implantation need intervention.

Q. How does adenomyosis affect IVF outcomes?

Ans : It can lower implantation rates and increase miscarriage risk. Suppression therapy before transfer often improves odds.

Q. How long after surgery should I wait before transfer?

Ans : Usually 2–3 months, depending on the procedure and healing. Your doctor will confirm with follow-up imaging.

Q. What are the risks of doing IVF without surgery?

Ans : If the lesion is significant, risks include lower implantation rates, higher miscarriage, and wasted embryos.

Q. Is surgery always worth the cost?

Ans : Not always. For small, non-cavity-distorting lesions, the benefit may be minimal. The decision should be individualized.

Next Steps

• Book a free 15-min nurse consult
• Upload your imaging and labs for review
• Request a customized cost breakdown before making your decision

Related Links

Uterine implantation

Intended Parents

Become a Surrogate 

Fixed‑Cost Packages

Upload Labs

Locations (NYC)

SART

CDC ART

ASRM