Elsevier

Fertility and Sterility

Volume 75, Issue 2, February 2001, Pages 405-410
Fertility and Sterility

Pacific Coast Reproductive Society
Impact of intramural leiomyomata in patients with a normal endometrial cavity on in vitro fertilization–embryo transfer cycle outcome

Presented in part at the 48th annual meeting of the Pacific Coast Reproductive Society, which was held on April 26–30, 2000 in Rancho Mirage, California.
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Abstract

Objective: Assess the impact of intramural uterine leiomyomata and a normal endometrial cavity on IVF-ET cycle outcome.

Design: Retrospective case-controlled analysis.

Setting: Tertiary-care–assisted reproductive technology program.

Patient(s): Three hundred ninety-nine consecutive fresh IVF-ET cycles were performed in patients with a normal precycle diagnostic hysteroscopy; patients were divided into four groups. Group 1: positive leiomyomata, age <40 years (n = 51 cycles); group 2: negative leiomyomata, age <40 years (n = 57 cycles); group 3: positive leiomyomata, age ≥40 years (n = 22 cycles); group 4: negative leiomyomata, age ≥40 years (n = 59 cycles). A subgroup of all group 2 patients aged 35–39 (group 2A, n = 113 cycles) was also evaluated as an additional control.

Intervention(s): Controlled ovarian hyperstimulation, IVF-ET.

Main Outcome Measure(s): Implantation (IR), live birth (LBR) rates.

Result(s): There were no significant differences in LBR among age-matched controls: group 1 (49%) versus 2 (57.5%) or 2A (57%) and group 3 (40.9%) versus 4 (32.2%). IR was significantly lower in group 1 (21.4%) versus 2 (33.3%) or 2A (33.9%) but not in group 3 (17.5%) versus 4 (11.6%). Implantation did not correlate with either mean leiomyoma diameter or volume.

Conclusion(s): [1] LBR was not affected by the presence of intramural leiomyoma in IVF-ET patients with hysteroscopically normal endometrial cavities. [2] A significant decrease in IR was only noted in patients <40 years old. [3] Given the relatively high LBR in all groups, prophylactic surgical intervention cannot be justified, but precycle hysteroscopy evaluation is recommended.

Keywords

Intramural leiomyoma
in vitro fertilization
hysteroscopy
implantation

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