Do uterine fibroids affect IVF outcomes?
The effect of myomectomy on implantation and pregnancy rates prior to assisted reproduction treatments is controversial. This study was designed to assess clinical outcomes of IVF cycles in women with uterine fibroids. A retrospective single-centre assessment of clinical outcomes of IVF/intracytoplasmic sperm injection (ICSI) treatments in infertile women in a 4-year span was carried out. All patients underwent detailed transvaginal ultrasound and hysteroscopy to precisely identify presence, location and intracavitary growth of uterine fibroids. Cumulative pregnancy, ongoing pregnancy and live birth rates were considered primary outcome measurements. Fifty-one women with fibroids (97 treatment cycles), 63 patients with previous myomectomy (127 cycles), and 106 infertile women who did not demonstrate fibroids anywhere in the uterus (215 cycles) were considered for the analysis. No significant difference was found for pregnancy and live birth rates between groups. Women with fibroids>4 cm required an increased number of cycles to obtain an ongoing pregnancy, compared with the other groups. The data do not support pre-IVF myomectomy in women with small-to-moderate uterine fibroids, regardless of their location. This represents valuable information in the counselling of women with fibroids before reproductive assisted cycles.
Department of Gynaecology, Obstetrics and Neonatology, University of Medical Science of Bari, Policlinico of Bari, Piazza Giulio Cesare, 11, 70100 Bari, Italy.
Antonella
A
Vimercati
Marco
M
Scioscia
Filomenamila
F
Lorusso
Anna Franca
AF
Laera
Giuseppina
G
Lamanna
Alfredo
A
Coluccia
Stefano
S
Bettocchi
Luigi
L
Selvaggi
Raffaella
R
Depalo
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000628:therapy*; D010535:Laparoscopy; D007813:Laparotomy; D007889:Leiomyoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery