Impact of intramural leiomyomata in patients with a normal endometrial cavity on in vitro fertilization-embryo transfer cycle outcome.
OBJECTIVE
Assess the impact of intramural uterine leiomyomata and a normal endometrial cavity on IVF-ET cycle outcome.


METHODS
Retrospective case-controlled analysis.


METHODS
Tertiary-care-assisted reproductive technology program.


METHODS
Three hundred ninety-nine consecutive fresh IVF-ET cycles were performed in patients with a normal precycle diagnostic hysteroscopy; patients were divided into four groups. Group 1: positive leiomyomata, age <40 years (n = 51 cycles); group 2: negative leiomyomata, age <40 years (n = 57 cycles); group 3: positive leiomyomata, age > or =40 years (n = 22 cycles); group 4: negative leiomyomata, age > or =40 years (n = 59 cycles). A subgroup of all group 2 patients aged 35-39 (group 2A, n = 113 cycles) was also evaluated as an additional control.


METHODS
Controlled ovarian hyperstimulation, IVF-ET.


METHODS
Implantation (IR), live birth (LBR) rates.


RESULTS
There were no significant differences in LBR among age-matched controls: group 1 (49%) versus 2 (57.5%) or 2A (57%) and group 3 (40.9%) versus 4 (32.2%). IR was significantly lower in group 1 (21.4%) versus 2 (33.3%) or 2A (33.9%) but not in group 3 (17.5%) versus 4 (11.6%). Implantation did not correlate with either mean leiomyoma diameter or volume.


CONCLUSIONS
[1] LBR was not affected by the presence of intramural leiomyoma in IVF-ET patients with hysteroscopically normal endometrial cavities. [2] A significant decrease in IR was only noted in patients <40 years old. [3] Given the relatively high LBR in all groups, prophylactic surgical intervention cannot be justified, but precycle hysteroscopy evaluation is recommended.
Surrey
E S
ES
Colorado Center for Reproductive Medicine, 799 E. Hampden Avenue, Suite #300, Englewood, Colorado 80110, USA. cerm@colorm.com
Lietz
A K
AK
Schoolcraft
W B
WB
D000328:Adult; D001755:Blastocyst / Q000502:physiology; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D010064:Embryo Implantation; D004624:Embryo Transfer; D004717:Endometrium / Q000473:pathology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007889:Leiomyoma / Q000150:complications* / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011673:Pulsatile Flow; D012044:Regression Analysis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D014594:Uterine Neoplasms / Q000150:complications* / Q000473:pathology; D014599:Uterus / Q000098:blood supply
D006063:Chorionic Gonadotropin; D004958:Estradiol; D005640:Follicle Stimulating Hormone