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Do uterine fibroids affect IVF outcomes?

Antonella Vimercati¹, Marco Scioscia, Filomenamila Lorusso

¹Department of Gynaecology, Obstetrics and Neonatology, University of Medical Science of Bari, Policlinico of Bari, Piazza Giulio Cesare, 11, 70100 Bari, Italy.

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Summary

Myomectomy before IVF may not improve pregnancy rates for women with small to moderate uterine fibroids. Larger fibroids (>4 cm) may require more cycles for ongoing pregnancy.

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Area of Science:

Reproductive Endocrinology
Infertility Research
Gynecologic Surgery

Background:

The impact of myomectomy on IVF outcomes remains debated.
Uterine fibroids can affect fertility and pregnancy rates.

Purpose of the Study:

To evaluate the clinical outcomes of IVF/ICSI in women with uterine fibroids.
To compare pregnancy and live birth rates between women with and without fibroids, and those who underwent myomectomy.

Main Methods:

Retrospective single-centre study of 4 years of IVF/ICSI treatments.
Detailed transvaginal ultrasound and hysteroscopy to characterize fibroids.
Analysis of cumulative pregnancy, ongoing pregnancy, and live birth rates.

Main Results:

No significant difference in pregnancy and live birth rates between groups (fibroids, post-myomectomy, no fibroids).
Women with fibroids >4 cm needed more cycles for ongoing pregnancy.
Data suggest no benefit of pre-IVF myomectomy for small-to-moderate fibroids.

Conclusions:

Pre-IVF myomectomy is not supported for small-to-moderate uterine fibroids.
Fibroid size >4 cm may impact the time to achieve ongoing pregnancy.
Findings aid in counseling women with fibroids undergoing assisted reproduction.