CLINICAN SURVEY: Proposed randomised controlled trial to evaluate the effectiveness of removing endometrial polyps and submucous fibroids to treat infertility and recurrent miscarriage

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Respondent name:

Hospital:

On average, how many women are diagnosed with endometrial polyps and submucous fibroids whilst undergoing infertility work up or treatments at your Centre/ Hospital in a month? (estimate or refer to hospital coding / audits if available)

Endometrial polyps ………. per month

Submucous fibroids ………. per month

On average, how many women in the above category are undergoing hysteroscopic surgery for removal of polyps or submucous fibroids in a month? (estimate or to refer hospital coding / audits if available)

Endometrial polyps ………. per month

Submucous fibroids ………. per month

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
a) Asymptomatic endometrial polyps?

(please detail e.g. size threshold.

This is required

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
b) Asymptomatic submucous fibroids?

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

Size (max. diameter):

Any

<1cm

1-2cm

>2cm

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

(* type 0 = 100%; intracavity; type 1 >/=50% intracavity; type 2 <50% intracavity)

FIGO type*:

0 only

1 only

2 only

0&1 only

all types

Other factors: (please specify)

This is required

Would you responses to Question 6 differ if the population where the polyp or submucous fibroid was detected, was in a women with recurrent miscarriage rather than infertility?

Yes

If yes, please specify

This is required

What is the average waiting time at your hospital for women to have an operative hysteroscopic procedure as a

(a) Day case procedure ... weeks

(b) Outpatient procedure ... weeks

Assuming the live birth rate within 12 months is 40% in women who do not have their endometrial POLYPS removed, what percentage improvement would cause you to routinely remove the POLYP via hysteroscopic surgery, factoring in the potential associated risks and costs of surgery? Consider the increase in absolute terms, e.g. an increase up to 50% would be 10%.

Assuming the live birth rate within 12 months is 40% in women who do not have their SUBMUCOSAL FIBROIDS removed, what percentage improvement would cause you to routinely remove the fibroid via hysteroscopic surgery, factoring in the potential associated risks and costs of surgery? Consider the increase in absolute terms, e.g. an increase up to 50% would be 10%.

What proportion (%) of your patients do you think would be willing to consider randomisation to a trial where “no-removal” of a diagnosed polyp or submucous fibroid is an option? ……….%

Do you think you patients would be more willing to consider randomisation to a trial where “delayed” rather than “no removal” of a diagnosed polyp or submucous fibroid was an option?

If Yes to Question 14. What do you think the maximum delay in scheduling removal would be acceptable to eligible women (please take into account your current waiting times for removal even if listed for removal)?
………. Months

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus NO removal:

Please state why not sure

This is required

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus DELAYED removal:

(please state why not sure)

This is required

CLINICAN SURVEY: Proposed randomised controlled trial to evaluate the effectiveness of removing endometrial polyps and submucous fibroids to treat infertility and recurrent miscarriage

Respondent name:

Hospital:

On average, how many women are diagnosed with endometrial polyps and submucous fibroids whilst undergoing infertility work up or treatments at your Centre/ Hospital in a month? (estimate or refer to hospital coding / audits if available)

On average, how many women in the above category are undergoing hysteroscopic surgery for removal of polyps or submucous fibroids in a month? (estimate or to refer hospital coding / audits if available)

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
a) Asymptomatic endometrial polyps?

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
b) Asymptomatic submucous fibroids?

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

(* type 0 = 100%; intracavity; type 1 >/=50% intracavity; type 2 <50% intracavity)

Would you responses to Question 6 differ if the population where the polyp or submucous fibroid was detected, was in a women with recurrent miscarriage rather than infertility?

What is the average waiting time at your hospital for women to have an operative hysteroscopic procedure as a

What proportion (%) of your patients do you think would be willing to consider randomisation to a trial where “no-removal” of a diagnosed polyp or submucous fibroid is an option? ……….%

Do you think you patients would be more willing to consider randomisation to a trial where “delayed” rather than “no removal” of a diagnosed polyp or submucous fibroid was an option?

If Yes to Question 14. What do you think the maximum delay in scheduling removal would be acceptable to eligible women (please take into account your current waiting times for removal even if listed for removal)?
………. Months

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus NO removal:

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus DELAYED removal:

Regarding the relative significance of polyps and submucous fibroids in adversely affecting reproductive outcomes, do you think:

Comments or suggestions

CLINICAN SURVEY: Proposed randomised controlled trial to evaluate the effectiveness of removing endometrial polyps and submucous fibroids to treat infertility and recurrent miscarriage

Page 1

Respondent name:

Hospital:

On average, how many women are diagnosed with endometrial polyps and submucous fibroids whilst undergoing infertility work up or treatments at your Centre/ Hospital in a month? (estimate or refer to hospital coding / audits if available)

On average, how many women in the above category are undergoing hysteroscopic surgery for removal of polyps or submucous fibroids in a month? (estimate or to refer hospital coding / audits if available)

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managinga) Asymptomatic endometrial polyps?

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managingb) Asymptomatic submucous fibroids?

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:(* type 0 = 100%; intracavity; type 1 >/=50% intracavity; type 2 <50% intracavity)

Would you responses to Question 6 differ if the population where the polyp or submucous fibroid was detected, was in a women with recurrent miscarriage rather than infertility?

What is the average waiting time at your hospital for women to have an operative hysteroscopic procedure as a

What proportion (%) of your patients do you think would be willing to consider randomisation to a trial where “no-removal” of a diagnosed polyp or submucous fibroid is an option? ……….%

Do you think you patients would be more willing to consider randomisation to a trial where “delayed” rather than “no removal” of a diagnosed polyp or submucous fibroid was an option?

If Yes to Question 14. What do you think the maximum delay in scheduling removal would be acceptable to eligible women (please take into account your current waiting times for removal even if listed for removal)?………. Months

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus NO removal:

Would you be willing to recruit into a trial to evaluate the effectiveness of hysteroscopic polypectomy and myomectomy comparing removal versus DELAYED removal:

Regarding the relative significance of polyps and submucous fibroids in adversely affecting reproductive outcomes, do you think:

Comments or suggestions

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
a) Asymptomatic endometrial polyps?

For women undergoing infertility work up or treatment, what is the current practice at your hospital for managing
b) Asymptomatic submucous fibroids?

If you ticked response to Question 6 (i.e., Asymptomatic submucous fibroids) as "Decision based on factors such as size, FIGO type, location etc" then please answer the following questions:

(* type 0 = 100%; intracavity; type 1 >/=50% intracavity; type 2 <50% intracavity)

If Yes to Question 14. What do you think the maximum delay in scheduling removal would be acceptable to eligible women (please take into account your current waiting times for removal even if listed for removal)?
………. Months