Effect of fibroids not distorting the endometrial cavity on the outcome of in vitro fertilization treatment: A retrospective cohort study

摘要

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.