Lei Yan1, Lingling Ding1, Chunyan Li2, Yu Wang3, Rong Tang1, Zi-Jiang Chen4. 1. Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China. 2. Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China. 3. School of Statistics, Renmin University of China, Beijing, People's Republic of China. 4. Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China. Electronic address: chenzijiang@hotmail.com.
Abstract
OBJECTIVE: To investigate the effect of fibroids that do not distort the endometrial cavity on IVF/intracytoplasmic sperm injection (ICSI) outcomes and to identify certain fibroid subgroups that may be deleterious to fertility outcomes. DESIGN: Retrospective cohort study. SETTING: University-based reproductive medicine center. PATIENT(S): A total of 10,268 patients undergoing IVF/ICSI between 2009 and 2011 in our unit. INTERVENTION(S): Transvaginal ultrasound and hysteroscopy; controlled ovarian hyperstimulation and IVF/ICSI; strict matching criteria. MAIN OUTCOME MEASURE(S): Cycle cancellation, clinical pregnancy, miscarriage, and delivery rates. RESULT(S): We included 249 patients with fibroids who underwent IVF/ICSI. Higher day 3 FSH levels were found in women with fibroids compared with in control subjects. No significant differences were found in IVF/ICSI outcomes between the two groups. Patients with intramural fibroids with the largest diameter <2.85 cm or the sum of reported diameters <2.95 cm had a significantly higher delivery rate than patients with larger fibroids. A significant negative effect on delivery rate was noted when intramural fibroids with the largest diameter greater than 2.85 cm were considered, compared with matched controls without fibroids. CONCLUSION(S): Our results suggest that although non-cavity-distorting fibroids do not affect IVF/ICSI outcomes, intramural fibroids greater than 2.85 cm in size significantly impair the delivery rate of patients undergoing IVF/ICSI.
OBJECTIVE: To investigate the effect of fibroids that do not distort the endometrial cavity on IVF/intracytoplasmic sperm injection (ICSI) outcomes and to identify certain fibroid subgroups that may be deleterious to fertility outcomes. DESIGN: Retrospective cohort study. SETTING: University-based reproductive medicine center. PATIENT(S): A total of 10,268 patients undergoing IVF/ICSI between 2009 and 2011 in our unit. INTERVENTION(S): Transvaginal ultrasound and hysteroscopy; controlled ovarian hyperstimulation and IVF/ICSI; strict matching criteria. MAIN OUTCOME MEASURE(S): Cycle cancellation, clinical pregnancy, miscarriage, and delivery rates. RESULT(S): We included 249 patients with fibroids who underwent IVF/ICSI. Higher day 3 FSH levels were found in women with fibroids compared with in control subjects. No significant differences were found in IVF/ICSI outcomes between the two groups. Patients with intramural fibroids with the largest diameter <2.85 cm or the sum of reported diameters <2.95 cm had a significantly higher delivery rate than patients with larger fibroids. A significant negative effect on delivery rate was noted when intramural fibroids with the largest diameter greater than 2.85 cm were considered, compared with matched controls without fibroids. CONCLUSION(S): Our results suggest that although non-cavity-distorting fibroids do not affect IVF/ICSI outcomes, intramural fibroids greater than 2.85 cm in size significantly impair the delivery rate of patients undergoing IVF/ICSI.
Authors: Hao Huang; Hongying Kuang; Fangbai Sun; Michael P Diamond; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter R Casson; Gregory M Christman; Karl R Hansen; Nanette Santoro; Esther Eisenberg; Heping Zhang Journal: Fertil Steril Date: 2019-03-27 Impact factor: 7.329
Authors: Bruce Pier; Christopher Crellin; Ashwini Katre; Michael G Conner; Lea Novak; Steven L Young; Rebecca Arend Journal: Reprod Sci Date: 2020-01-01 Impact factor: 3.060