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Fibroids and in-vitro fertilization: which comes first?
1Section of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
Current Opinion in Obstetrics & Gynecology
|May 5, 2005
Summary
Uterine fibroids, particularly those distorting the endometrial cavity, can negatively impact in-vitro fertilization (IVF) outcomes. Myomectomy is recommended for fertility preservation in such cases.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Infertility Research
Background:
- The impact of uterine fibroids on fertility remains debated.
- Submucosal, intramural, and subserosal fibroids may affect reproductive outcomes.
Purpose of the Study:
- To review studies on fibroid effects on in-vitro fertilization (IVF).
- To discuss fibroid evaluation and management for fertility.
Main Methods:
- Literature review of past and recent studies.
- Analysis of data on fibroid location, size, and IVF outcomes.
- Evaluation of medical and surgical management options.
Main Results:
- Fibroid location and size significantly impact IVF success.
- Endometrial cavity distortion adversely affects IVF outcomes.
- Myomectomy is the standard for improving fertility.
Conclusions:
- Myomectomy is indicated for fibroids distorting the endometrial cavity.
- Consider myomectomy for large fibroids or failed IVF cycles.
- Newer treatments require further fertility outcome data.