Effects of the Distance between Small Intramural Uterine Fibroids and the Endometrium on the Pregnancy Outcomes of in Vitro Fertilization-Embryo Transfer

Abstract

Aim: To explore the effects of the distance between small intramural uterine fibroids (≤4 cm) and the endometrium on the outcomes of in vitro fertilization-embryo transfer (IVF-ET). Methods: We prospectively analyzed pregnancy outcomes in 117 infertile women with small intramural uterine fibroids and 117 infertile women without uterine fibroids who all underwent IVF-ET. The size and number of small intramural uterine fibroids and the shortest distance between the small intramural uterine fibroids and the endometrium were measured by transvaginal three-dimensional ultrasound. The endometrial and subendometrial blood flow parameters, implantation rate, clinical pregnancy rate, abortion rate and live birth rate were compared between the women with and without small uterine fibroids and among the different shortest distances (≤1, 1-3 and >3 mm). The effects of the size and number of small intramural uterine fibroids on IVF-ET outcomes were observed. Results: The endometrial volume on ET day, the implantation rate and the live birth rate were significantly lower, but the abortion rate was significantly higher, in the women with small intramural uterine fibroids than in those without uterine fibroids (p < 0.05). The endometrial flow index was higher in the shortest distance ≤1-mm group than in the groups with 1-3 and >3 mm, and the implantation rate was higher in ≤1-mm group than in the >3-mm group (p < 0.05). There were no significant differences in clinical outcomes between different sizes and numbers of small intramural uterine fibroids. Conclusion: Small intramural uterine fibroids can affect IVF-ET outcomes. Compared with other shortest distances (1-3 and >3 mm), the shortest distance of ≤1 mm has a higher implantation rate.

The Effect of Uterine Fibroids on Infertility: A Systematic Review

“…[27][28][29][30][31] In contrast, there are studies that demonstrate an unfavorable effect on IVF pregnancy rates in women with fibroids that do not appear to encroach the endometrial cavity. 26,[32][33][34][35][36][37] In one study, nonencroaching fibroids decreased the chances of ongoing pregnancy after IVF by half. 37 Another study revealed that implantation rates after IVF were 4.3% in women with submucosal fibroids and 6.4% in women with intramural fibroids, in comparison to 15.7% in women without fibroids.…”

The Impact of Noncavity-Distorting Intramural Fibroids on the Efficacy of In Vitro Fertilization-Embryo Transfer: An Updated Meta-Analysis

“…Especially, 23 of these studies have controlled the potential confounding factors by matching the age, number of embryos, number of cycles, and/or other factors between the study and the control groups. 5 other studies randomly had women enrolled into the control group from the same population without factors matched [ 28 , 30 , 32 , 44 , 51 ], but in the studies of Lu and Long, the age and some other important factors had no statistical difference between the study and control groups [ 28 , 30 ].…”

“…The deficiency of this meta-analysis is mainly due to the heterogeneity among the included studies. Firstly, 7 of the 28 studies were prospective [ 30 , 35 , 39 , 42 , 43 , 46 , 48 ], but the others were retrospective in design. Secondly, 10 of the 28 studies recorded a woman once because they only enrolled the first cycle of a woman undergoing IVF treatment [ 29 , 34 , 37 , 39 , 40 , 45 , 47 , 48 , 50 , 53 ], but the others may have recorded a woman more than one time because they enrolled every cycle of the previous IVF treatments.…”

Mitochondrial DNA Haplogroup R Confers a Genetic Risk Factor for Intrauterine Adhesion in Han Women Population

“…Inclusion criteria were as follows: patients had severe IUA confirmed by the diagnosis of hysteroscopy according to the American Fertility Society in 1988, and their clinical manifestations included amenorrhea, decrease in menstrual flow, infertility and repeated miscarriage [15,16]. Exclusion criteria were as follows: patients had a history of irregular menstrual cycle or abnormal uterine bleeding, abnormal sex hormone levels, sex hormone therapy, cardiovascular, liver and thrombotic diseases and ovarian tumors as well as intrauterine diseases such as endometrial polyps and submucosal uterine fibroids.…”