The effect of small intramural uterine fibroids on the cumulative outcome of assisted conception

Abstract

Small intramural fibroids are associated with a significant reduction in the cumulative pregnancy, ongoing pregnancy and live birth rates after three IVF/ICSI cycles.

Uterine artery embolization for fibroids is associated with an increased risk of miscarriage

“…Referring to studies identified in recent reviews, the pooled miscarriage rate among 1,121 pregnancies with untreated intramural fibroids was 16.5% (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) (Table 3). In stark contrast, we found that the overall miscarriage rate for all 227 UAE pregnancies was 35.2%, more than double that for the control group (P<.0001; OR 2.8; 95% CI 2.0-3.8) (Table 3).…”

“…Given that individual fibroid subtypes have differing effects on miscarriage rates with submucosal and intramural categories being the most detrimental and subserosal less so (22)(23)(24), it was important to select a control group having comparable fibroid subtypes to those in women having UAE. On the basis of the five articles discussed in the preceding paragraph that identified intramural fibroids as the predominant category in UAE patients (7,8,(12)(13)(14), we selected patients derived from 14 studies having intramural fibroids as the principal fibroid component (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) for comparative analysis of miscarriage outcomes. With regard to the control group for obstetric outcomes, we selected patients from 10 controlled studies that examined late pregnancy complications in women with fibroids (25,28,(39)(40)(41)(42)(43)(44)(45)(46).…”

Short communication: Validity of the in vitro fertilisation league tables: influence of patients’ characteristics

“…For example, a number of reports have highlighted the influence of ethnicity on outcome of IVF treatment, [15][16][17][18][19] ), although the direction of its impact (positive or negative) is unclear, mainly due to the small number of patients from [20][21][22][23] Likewise, the presence of uterine fibroids has been shown to reduce the implantation and pregnancy potential after IVF 24,25 and is more common in certain racial groups. The primary cause of infertility, a factor reported to have an impact on IVF outcome 11,26,27 was also different in the two studied groups.…”

The destiny of myomas: should we treat small submucous myomas in women of reproductive age?

“…Indeed, assessing the real impact of such endoscopic technique on subsequent fertility appears to be hampered by difficulties in controlling for multiple infertility factors, by the varying number of submucous myomas resected, as well as by the presence of concomitant intramural fibroids (37,(49)(50)(51).…”