Uterine polyps, also called endometrial polyps, are growths arising from the lining of the uterus. Most are benign, meaning they are not cancerous.

What are the symptoms?

Some people have no symptoms. Others may notice:

• Spotting between periods
• Irregular or heavy menstrual bleeding
• Difficulty conceiving

Can they affect fertility?

Polyps may interfere with implantation, but having a polyp does not mean pregnancy is impossible. Their significance depends on your symptoms, scan findings and fertility history.

How are they diagnosed?

Transvaginal ultrasound may detect a polyp. A saline sonohysterogram provides a clearer view of the uterine cavity. Hysteroscopy uses a thin camera passed through the cervix to examine the cavity directly and can also allow removal.

Does every polyp need removal?

No. Some small polyps without symptoms may be monitored. Removal may be considered if you have abnormal bleeding or difficulty conceiving. Whether removal improves fertility depends on the circumstances; it does not guarantee pregnancy.

If a polyp is found during fertility testing, discuss monitoring or hysteroscopic removal with your gynecologist or fertility specialist.

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Adenomyosis occurs when tissue similar to the uterine lining is found within the muscular wall of the uterus. It differs from endometriosis, which involves tissue outside the uterus. Both conditions can occur together.

What are the symptoms?

Some people have no symptoms. Others experience:
• Heavy menstrual bleeding
• Painful periods
• Pelvic discomfort

Can it affect fertility?

Adenomyosis may reduce the chances of successful fertility treatment in some patients. However, a diagnosis does not mean pregnancy is impossible. Its effects on natural conception are less clear, and your age and other fertility factors also matter.

How is it diagnosed?

Transvaginal ultrasound is usually the first test. MRI may help clarify uncertain findings or provide more detail.

Does everyone need treatment?

No. Treatment depends on your symptoms and pregnancy plans. Some hormonal treatments used to control symptoms prevent pregnancy while you use them, so tell your provider if you are trying to conceive.

If your scan suggests adenomyosis, discuss the findings with your gynecologist or fertility specialist to understand your options.

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These terms are related, but they do not all mean the same thing.

PCOS — Polycystic Ovary Syndrome
A hormonal condition that may involve irregular ovulation, elevated androgens and metabolic concerns such as insulin resistance. Despite the name, ovarian cysts are not required for diagnosis.

PCOM — Polycystic Ovarian Morphology
This describes an ovarian appearance on ultrasound, with an increased number of small follicles and/or increased ovarian volume. These follicles are not the same as ovarian cysts. PCOM alone does not mean you have PCOS or infertility.

PMOS — Polyendocrine Metabolic Ovarian Syndrome
Introduced in May 2026, PMOS is the new name for PCOS. It highlights the condition’s broader hormonal and metabolic effects beyond the ovaries. It is not a separate disease.

How is it diagnosed?
In adults, diagnosis generally requires two of the following after excluding other causes:
• Irregular or absent ovulation
• Clinical or blood-test evidence of elevated androgens
• PCOM on ultrasound, or an appropriate AMH result as an alternative

AMH alone cannot diagnose the condition. Different criteria apply to adolescents.

Can you still become pregnant?
Yes. Many people conceive naturally or with treatment. An individualized assessment can help clarify ovulation, metabolic health and fertility needs.

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Yes. Fertility usually returns after stopping reversible contraception, sometimes before your first period. How quickly it returns depends on the method you used.

How soon can you conceive?

• Pill, patch or vaginal ring: pregnancy can happen soon after stopping, although regular cycles may take a few months to return.
• IUD or implant: fertility generally returns quickly after removal.
• Contraceptive injection: ovulation may take several months to return, sometimes a year or longer after the last injection.

Does birth control cause infertility?

Reversible contraception does not generally cause lasting infertility. However, irregular cycles that existed before treatment may return. Age and underlying conditions can also affect your chances of pregnancy.

Do you need to wait before trying?

For most methods, no routine waiting period is needed. Discuss your medications and preconception care with your healthcare provider.

When should you seek advice?

If your period is late, take a pregnancy test. If periods have not returned within three months after stopping the pill, seek advice.

Consider a fertility assessment after 12 months of trying if under 35, or six months if 35 or older. Seek advice sooner for irregular or absent periods, known fertility concerns, or if over 40.

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After an uncomplicated early miscarriage, you can usually try again once bleeding and other symptoms have stopped, the miscarriage is confirmed complete, and you feel physically and emotionally ready. There is generally no need to wait several months unless your healthcare provider recommends it.

Can pregnancy happen before your next period?

Yes. Ovulation may return as soon as two weeks after an early miscarriage, before your first period. Use contraception if you are not ready to conceive.

When might you need to wait?

Individual advice is important after a later pregnancy loss, infection, significant blood loss or complications.

Ectopic and molar pregnancies require different follow-up:

• After methotrexate treatment, avoid pregnancy for at least three months and follow your specialist’s instructions.
• After a molar pregnancy, wait until your specialist confirms it is safe to try, following the required monitoring.

What about emotional recovery?

There is no single right timeline. Some people feel ready quickly; others need more time. Neither choice is wrong.

Complete recommended follow-up and discuss any ongoing symptoms or repeated losses with your healthcare provider. Most people who experience a miscarriage go on to have a successful pregnancy.

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Yes. Some people with endometriosis have little or no pain. They may first discover it during investigations for difficulty conceiving.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can cause inflammation, scar tissue and ovarian cysts called endometriomas.

Does no pain mean mild disease?

Not necessarily. Pain severity does not reliably reflect the extent of endometriosis. Comfortable periods do not rule it out.

Can it affect fertility?

Endometriosis may affect the ovaries, fallopian tubes and surrounding tissues, making conception more difficult. However, many people with endometriosis conceive naturally. Difficulty conceiving alone does not confirm the condition.

Can ultrasound detect it?

Ultrasound can identify endometriomas and some deep endometriosis, especially when performed by an experienced specialist. A normal scan does not exclude superficial endometriosis.

Does everyone need surgery?

No. Assessment may include medical history, examination and imaging. Laparoscopy may be considered in selected cases, but it is not always required before treatment.

If pregnancy is taking longer than expected, discuss a fertility assessment for both partners. Your care should reflect your age, test results and pregnancy goals—not pain alone.

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A mild ache or sharp twinge on one side of your lower abdomen may occur around ovulation. Known as mittelschmerz, this discomfort can last from a few minutes to one or two days, often about 14 days before your next period—not necessarily on cycle day 14.

Does it confirm ovulation?

No. Mid-cycle pain may be related to ovulation, but pain alone cannot confirm that an egg has been released or pinpoint your most fertile days. Other conditions can cause similar symptoms.

Does pain mean better fertility?

No. Having ovulation pain does not mean you are more fertile. Many people ovulate without feeling any discomfort.

If you are trying to conceive, track your cycle and other fertility signs rather than relying on pain alone.

When should you seek help?

Discuss persistent, recurring or unusual pelvic pain with your healthcare provider. Possible causes include ovarian cysts, endometriosis or infection.

Seek urgent medical assessment for severe pain, fever, vomiting, or pain when pregnancy is possible. Severe pain with fainting, shoulder-tip pain or heavy bleeding requires emergency care.

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Yes—natural pregnancy is possible with one healthy, open fallopian tube and at least one functioning ovary. Losing a tube does not automatically mean infertility or that you need IVF.

What affects your chances?

Your age, ovulation, the health of the remaining tube and your partner’s sperm quality all matter. The reason a tube was removed—such as an ectopic pregnancy, infection or endometriosis—may also influence fertility.

Do you only have a chance every other month?

Not necessarily. Ovaries do not strictly alternate each month, and the remaining tube can sometimes collect an egg released from the opposite ovary. Having one tube does not simply halve your chances.

When should you seek advice?

Discuss your pregnancy plans early if you have known tubal damage or a previous ectopic pregnancy. Your healthcare provider may recommend testing the remaining tube and reviewing other fertility factors. IVF may be an option when needed.

After a positive pregnancy test

If you have had an ectopic pregnancy, contact your healthcare provider promptly. An early ultrasound can help confirm that the pregnancy is inside the uterus. Seek urgent care for severe abdominal pain, shoulder-tip pain, dizziness or fainting.

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Hydrosalpinx occurs when a fallopian tube becomes blocked near its outer end and fills with fluid. It may affect one or both tubes, often following a pelvic infection, previous surgery or endometriosis.

Many people have no symptoms, while others experience pelvic pain or unusual vaginal discharge.

How can it affect fertility?

A damaged tube can prevent sperm and egg from meeting and increase the risk of ectopic pregnancy. Fluid may also flow back into the uterus, interfering with implantation and reducing the chance of pregnancy through IVF.

How is it diagnosed?

An HSG—a contrast X-ray used to assess the fallopian tubes—and ultrasound may help identify hydrosalpinx. Laparoscopy is sometimes needed for further assessment or treatment.

Can you still become pregnant?

Natural pregnancy may remain possible if the other tube is healthy and open. IVF bypasses the tubes, but your fertility specialist may recommend removing the affected tube or blocking its connection to the uterus before treatment.

The best approach depends on the extent of damage, your symptoms and your fertility goals. Discuss the findings with your fertility specialist to plan appropriate care.

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A semen analysis measures sperm count, movement (motility) and shape (morphology). It does not directly assess the integrity of the genetic material inside sperm.

What is sperm DNA fragmentation?

It refers to breaks in the DNA carried within sperm. Specialized tests assess this damage, providing information beyond a routine semen analysis. Normal semen results do not necessarily rule out increased DNA fragmentation.

Can it affect fertility?

Higher fragmentation has been associated with difficulty conceiving and an increased risk of pregnancy loss. However, an elevated result does not mean pregnancy is impossible or prove the cause of a miscarriage.

Who should consider testing?

Testing is not routinely recommended as part of an initial fertility evaluation. A specialist may recommend it in selected situations, such as recurrent pregnancy loss.

What are the limitations?

Testing methods and reference ranges differ. A result cannot reliably predict an individual couple’s pregnancy outcome and should be interpreted alongside both partners’ medical history and other findings.

Speak with your fertility specialist or reproductive urologist about whether testing would help guide your care.

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