Premium
Factors associated with successful pregnancy in women of late reproductive age with uterine fibroids who undergo embryo cryopreservation before surgery
Author(s) -
Takahashi Nozomi,
Harada Miyuki,
Tanabe Ryosuke,
Takayanagi Akane,
Izumi Gentaro,
Oi Nagisa,
Hirata Tetsuya,
WadaHiraike Osamu,
Fujii Tomoyuki,
Osuga Yutaka
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13754
Subject(s) - medicine , pregnancy , uterine fibroids , embryo transfer , in vitro fertilisation , gynecology , obstetrics , assisted reproductive technology , gestation , pregnancy rate , uterine cavity , cryopreservation , embryo , infertility , uterus , genetics , biology , microbiology and biotechnology
Aim The objective of this study is to determine the factors associated with successful pregnancy in women of late reproductive age with uterine fibroids who undergo embryo cryopreservation before surgery (ECBS). Methods Patients who underwent in vitro fertilization treatment with controlled ovarian stimulation from November 2010 to January 2017 in our university hospital were included. Twenty‐two patients older than 35 years of age at the first visit with cavity‐distorting uterine fibroids underwent ECBS, a three‐step therapeutic approach consisting of oocyte pick‐up, myomectomy and embryo transfer (ET), which are performed in this order. We retrospectively calculated the pregnancy rate and determined the factors associated with successful pregnancy. Results The mean age at ET of the patients who underwent ECBS was 40.9 years, with a pregnancy rate per ET of 36.8% (21/57). Of 22 patients, 10 (45.5%) successfully continued pregnancy beyond 12 weeks of gestation (ongoing pregnancy). An ongoing pregnancy was observed only among the patients with more than three frozen embryos. The ongoing pregnancy rates of patients with ≤five fibroids and ≤5 cm in the maximal diameter were significantly higher compared to the respective remaining group (90.0% vs 14.3% and 87.5% vs 33.3%). Conclusion ECBS is an effective strategy for infertile women of late reproductive age with cavity‐distorting uterine fibroids, especially when it is applied to the patients who can freeze at least three embryos before myomectomy, with five or less fibroids smaller than 5 cm in the maximal diameter.