Uterine leiomyomas and their effect on in vitro fertilization outcome: a retrospective study.
OBJECTIVE
The effect of uterine leiomyomas on the outcome of in vitro fertilization (IVF) treatment has been controversial. This study was undertaken to clarify influence of fibroids on IVF success, in a large population with age and other potential confounding variables controlled for in the analysis.


METHODS
A population of 141 patients with and 406 without leiomyomata undergoing their first IVF cycle was studied.


RESULTS
The association between uterine leiomyomas and assisted reproduction treatment outcome was not statistically significant (OR = 0.73, 95% CI: 0.49-1.19, p = 0.21) after controlling for age and other risk factors. Also, fibroids neither affected the risk of spontaneous abortion (OR = 1.06, 95% CI: 0.44-2.60) nor the risk of ectopic pregnancy (OR = 0.78, 95% CI: 0.08-8.02). Location of fibroids (intramural vs. submucosal/subserosal) and their size had no significant effect on pregnancy outcome.


CONCLUSIONS
Results from our analyses indicated that in vitro fertilization outcome was not affected by the presence of uterine leiomyomas. Therefore, in patients with normal uterine cavities and fibroids less than a certain size (i.e., < 7 cm), undergoing myomectomies as a prerequisite for assisted reproduction treatment is seriously questionable.
Jun
S H
SH
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Ginsburg
E S
ES
Racowsky
C
C
Wise
L A
LA
Hornstein
M D
MD
D000328:Adult; D000367:Age Factors; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007889:Leiomyoma / Q000150:complications*; D016015:Logistic Models; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000503:physiopathology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000150:complications*