title: Reproductive Outcome of Infertile Patients with Fibroids Based on the Patient and Fibroid Characteristics; Optimal and Personalized Management.
abstract: OBJECTIVE
  To analyze the detailed clinical course of infertile patients with uterine fibroids and to identify optimal and personalized treatment based on the patient or fibroid characteristics.
  
  
  METHODS
  Retrospective analysis of a case series was performed on 176 infertile patients with fibroids. The patients were classified into different groups according to different treatments (conservative infertility treatment, myomectomy and non-myomectomy surgery). Patient or fibroid characteristics for different groups were analyzed for a possible correlation with the reproductive outcome.
  
  
  RESULTS
  The cumulative pregnancy rates by conservative treatment plateaued in 1 year. Myomectomy improved the reproductive outcome in patients who did not conceive with conservative infertility treatments. The most important determinant of the reproductive outcome in patients by conservative treatment prior to surgery was a past patient history of pregnancy. The most important determinant of the reproductive outcome after myomectomy was patient age.
  
  
  CONCLUSIONS
  Myomectomy should be considered when infertile patients with fibroids do not conceive within 1 year of conservative infertility treatments. The most important determinant of reproductive outcome after myomectomy is patient age. Therefore, for patients younger than 40, the treatment schedule should be carefully considered so that the patients can sufficiently benefit from myomectomy and assisted reproductive technology.
authors.affiliation: Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Tsuji
authors.forename: Nahoko
authors.initials: N
authors.lastname: Fujinami
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kotani
authors.forename: Takako
authors.initials: T
authors.lastname: Tobiume
authors.forename: Masato
authors.initials: M
authors.lastname: Aoki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Murakami
authors.forename: Akiko
authors.initials: A
authors.lastname: Kanto
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Takaya
authors.forename: Masayo
authors.initials: M
authors.lastname: Ukita
authors.forename: Masao
authors.initials: M
authors.lastname: Shimaoka
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Nakai
authors.forename: Ayako
authors.initials: A
authors.lastname: Suzuki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mandai
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D057285:Precision Medicine; D011247:Pregnancy; D018873:Pregnancy Rate; D012098:Reproduction; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*