Premium
Myomas, Pregnancy Outcome, and In Vitro Fertilization
Author(s) -
BULLETTI CARLO,
DE ZIEGLER DOMINIQUE,
LEVI SETTI PAOLO,
CICINELLI ETTORE,
POLLI VALERIA,
STEFANETTI MARCO
Publication year - 2004
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1335.010
Subject(s) - medicine , infertility , pregnancy , obstetrics , gynecology , pregnancy rate , in vitro fertilisation , uterine fibroids , fertility , uterine cavity , female infertility , assisted reproductive technology , uterus , population , endocrinology , genetics , environmental health , biology
A bstract : Uterine fibroids have been reported in 27% of infertile women, and 50% of women with unexplained infertility become pregnant after myomectomy. The age at which a first pregnancy occurs is increasing from the thirties to the forties. This increase and the recurrence rate of leiomyomas from 15 to 30% points to the effect of myomas on the infertility. Mechanisms by which myomas may cause infertility are abnormal uterine contractility, elongation of the uterine cavity, and distortion of uterine vascularization. Surgery may have beneficial or adverse effects without clear data on its effect on the assisted reproductive technology (ART) procedures. The present study was undertaken to establish the impact of surgical removal of myomas on fertility and infertility of patients undergoing ART procedures. Patients who underwent surgical removal of myomas before in vitro fertilization (Group A) had a cumulative success rate of 33% for one to three procedures (28 clinical pregnancies in 84 patients) and delivery rate of 25% (21 live births in 84 patients). Patients who underwent in vitro fertilization without previous surgery (Group B) had a 15% clinical pregnancy rate (13 pregnancies in 84 patients) ( P < 0.05 ) and 12% delivery rate (10 deliveries in 84 pregnancies) ( P < 0.05 ). Abortion rates were 7% (8 deliveries in 84 patients) and 4% (3 deliveries in 84 patients) in Groups A and B, respectively. This study confirms the beneficial effect of surgical removal of fibroids before undergoing ART procedures.