Effect of Fibroids on Fertility in Patients Undergoing Assisted Reproduction

Abstract

Objective: The aim of this study is to evaluate the current data to understand the impact of intramural leiomyomata on pregnancy outcome in assisted reproduction. Patients and Methods: In this review, articles were found by means of computerized Medline and Cochrane Library search using the key words uterine myomata, leiomyomata, fibroids, implantation, pregnancy, infertility and in vitro fertilization. Limitations were English, human, 1990–2002. Inclusion criteria were pregnancy data on in vitro fertilization, intramural myomata with no cavitary distortion and control groups without myomas for each patient with a myoma. Results: There was a significant negative impact on implantation rate in the intramural myomata groups versus the control groups, 16.4 vs. 27.7% OR 0.62 (0.48–0.8). The delivery rate per transfer cycle was also significantly lower (myomata vs. control), 31.2 vs. 40.9% OR 0.69 (0.50–0.95). Conclusion: Our study supports the notion that patients with intramural fibroids have a lower implantation rate per cycle. The studies did not shed new light on the size of intramural myomata that could affect the outcome. In previous failed in vitro fertilization cycles, microsurgical removal of myomata must be considered.

A myoma uteri diagnosztikája és kezelése

“…Korlátozott számban elérhetők ilyen jellegű munkák, amelyek eredményei alapján a submucosus myomák eltávolításának fertilitásjavító hatása lehet, míg az intramuralis gócok eltávolításának szükségessége még kérdé-ses [14]. A méh üregét deformáló gócok méhtükrözés során történő eltávolítása Bettocchi munkája alapján is indokoltnak tűnik [16], míg Benecke vizsgálatai alapján az intramuralis myomák eltávolítása egyértelműen javítja az asszisztált reprodukciós technikák eredményességét [17].…”

Laparoscopic Myomectomy in Infertility Treatment

“…fertility have led to the need for uterine leiomyomas analysis in relation to the gestation [1]. The relationship between the uterine fibroid and infertility, except in evident cases (i.e.…”

“…Disorders of microvascularisation in endometrium, and the influences on the gestational implantation stages are still not fully revealed. Uterine leiomyoma is present in approximately 10% of the cases on patients with infertility [1,2]. If it is demonstrated a causal link between the uterine fibroids and infertility, than surgical treatment should be indicated [2].…”

Hysteroscopic morcellation

“…Fibroids are present in approximately 5-10% of the patients presenting with infertility; however, they were found to be the sole identified factor in only 1-2,4% of the infertile patients [13,14]. Andreoli researched the statistics of many authors and concluded that out of 3712 cases of myomectomies for fibroids associated with infertility, 1311 patients (36,1%) got pregnant [15].…”