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CLINICAL ASSISTED REPRODUCTION: Uterine Leiomyomas and Their Effect on In Vitro Fertilization Outcome: A Retrospective Study
Authors:Sunny H. Jun  Elizabeth S. Ginsburg  Catherine Racowsky  Lauren A. Wise  Mark D. Hornstein
Affiliation:(1) Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Abstract:Purpose: The effect of uterine leiomyomas on the outcome of in vitro fertilization (IVF) treatment has been controversial. This study was undertaken to clarify influence of fibroids on IVF success, in a large population with age and other potential confounding variables controlled for in the analysis.Methods: A population of 141 patients with and 406 without leiomyomata undergoing their first IVF cycle was studied.Results: The association between uterine leiomyomas and assisted reproduction treatment outcome was not statistically significant (OR = 0.73, 95% CI: 0.49–1.19, p = 0.21) after controlling for age and other risk factors. Also, fibroids neither affected the risk of spontaneous abortion (OR = 1.06, 95% CI: 0.44–2.60) nor the risk of ectopic pregnancy (OR = 0.78, 95% CI: 0.08–8.02). Location of fibroids (intramural vs. submucosal/subserosal) and their size had no significant effect on pregnancy outcome.Conclusions: Results from our analyses indicated that in vitro fertilization outcome was not affected by the presence of uterine leiomyomas. Therefore, in patients with normal uterine cavities and fibroids less than a certain size (i.e., <7 cm), undergoing myomectomies as a prerequisite for assisted reproduction treatment is seriously questionable.
Keywords:assisted reproduction cycle  effect on in vitro fertilization outcome  fibroids  myomectomy  uterine leiomyomas
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