Effect of intramural, subserosal, and submucosal uterine fibroids on the outcome of assisted reproductive technology treatment.
OBJECTIVE
To investigate the effect of subserosal, intramural, and submucosal fibroids on the outcome of assisted reproductive technology (ART) treatment.


METHODS
A retrospective comparative study.


METHODS
A tertiary referral center for infertility.


METHODS
Treatment outcome of 106 ART cycles in 88 patients with uterine fibroids (33 subserosal, 46 intramural without cavity distortion, and 9 submucosal) was compared with that of 318 ART cycles in age-matched patients without fibroids.


METHODS
Controlled ovarian hyperstimulation and ART.


METHODS
Findings on transvaginal uterine ultrasonography performed before the initiation of treatment and pregnancy and implantation rates.


RESULTS
The pregnancy rates per transfer were 34.1%, 16.4%, 10%, and 30.1% in the patients with subserosal fibroids, intramural fibroids, submucosal fibroids and no fibroids, respectively. The implantation rates were 15.1%, 6.4%, 4.3%, and 15.7%, respectively. Both rates were significantly lower in patients with intramural fibroids than in those with subserosal fibroids or no fibroids.


CONCLUSIONS
Pregnancy and implantation rates were significantly lower in the groups of patients with intramural and submucosal fibroids, even when there was no deformation of the uterine cavity. Pregnancy and implantation rates were not influenced by the presence of subserosal fibroids. Surgical or medical treatment should be considered in infertile patients who have intramural and/or submucosal fibroids before resorting to ART treatment.
Eldar-Geva
T
T
Monash In Vitro Fertilization, Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia. teldar@monashivf.edu.au
Meagher
S
S
Healy
D L
DL
MacLachlan
V
V
Breheny
S
S
Wood
C
C
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007889:Leiomyoma / Q000150:complications*; D009092:Mucous Membrane; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012016:Reference Values; D012189:Retrospective Studies; D012704:Serous Membrane; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications*