Effect of myomectomy on the outcome of assisted reproductive technologies.
OBJECTIVE
To evaluate the impact of myomectomy on in vitro fertilization-embryo transfer (IVF-ET) and oocyte donation cycle outcome.


METHODS
Retrospective case-controlled study of consecutive fresh IVF-ET and oocyte donation patients during a 2-year interval.


METHODS
Private assisted reproductive technology (ART) center.


METHODS
Patients with submucosal leiomyomata resected hysteroscopically (group A: 15 oocyte donor recipients; group 1 = 31 IVF-ET patients) and those with intramural components or strictly intramural leiomyomata that distorted or impinged upon the endometrial cavity resected at laparotomy (group B = 26 oocyte donor recipients; group 2 = 29 IVF-ET patients).


METHODS
Precycle hysteroscopic or abdominal myomectomy and subsequent fresh IVF-ET or oocyte donation.


METHODS
Results of controlled ovarian hyperstimulation as well as ongoing pregnancy and implantation rates were evaluated in comparison with contemporaneous patient groups without such lesions (group C = 552 oocyte donor recipients; group 3: 896 IVF-ET patients).


RESULTS
As would be expected, the mean number and size of leiomyomata were significantly larger in patients who underwent abdominal myomectomy. However, neither ongoing pregnancy nor implantation rates were significantly different in comparison with controls among either oocyte donor recipients (group A: 86.7%, 57.8%; group B: 84.6%, 55.2%; group C 77%, 49.1%). The findings were similar for those undergoing IVF-ET in comparison with controls (group 1: 61%, 24%; group 2: 52%, 26%; group 3: 53%, 23%).


CONCLUSIONS
Precycle resection of appropriately selected clinically significant leiomyomata results in IVF-ET or oocyte donation cycle outcomes that are similar to controls.
Surrey
Eric S
ES
Colorado Center for Reproductive Medicine, Englewood, Colorado 80113, USA. esurrey@colocrm.com
Minjarez
Debra A
DA
Stevens
John M
JM
Schoolcraft
William B
WB
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000453:epidemiology / Q000601:surgery*; D018587:Oocyte Donation / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000601:surgery*