Monday, March 28, 2011

Fibroids not encroaching the endometrial cavity and IVF success rate: a prospective study

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Edgardo Somigliana1,*, Silvia De Benedictis1,2, Paolo Vercellini1,2, Anna Elisa Nicolosi1, Laura Benaglia1,2, Claudia Scarduelli1, Guido Ragni1 and Luigi Fedele1,2
1Department of Obset/Gynecol-Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy
2Università degli Studi di Milano, Milan, Italy *Correspondence address. Tel: +39-349-2267868; E-mail: dadosomigliana{at}yahoo.itReceived August 17, 2010. Revision received December 28, 2010. Accepted January 13, 2011. BACKGROUND The impact of fibroids, not encroaching the endometrial cavity, have on the rate of success of IVF is still controversial. Recent meta-analyses suggest a detrimental effect of intramural lesions but not subserosal lesions. However, they also emphasize the need for further evidence. In order to elucidate this, we designed a prospective cohort study to compare the rate of success of IVF in women with and without fibroids.

METHODS Exposed women were those with asymptomatic intramural or subserosal fibroids with a diameter below 50 mm and who were selected for IVF. Unexposed women were those free of fibroids, who were matched to cases by age and number of previous IVF cycles. All recruited patients underwent hystero-sonography to rule out intra-cavitary lesions.

RESULTS There were 119 cases and 119 controls recruited. The number of clinical pregnancies in women with and without fibroids was 28 (24%) and 22 (19%), respectively (P= 0.43). The adjusted odds ratio (OR) for pregnancy in affected women was 1.38 [95% confidence interval (CI): 0.73–2.60]. The number of deliveries was 22 (18%) and 16 (13%), respectively (P= 0.38). The adjusted OR was 1.45 (95% CI: 0.71–2.94). Similar results emerged when focusing exclusively on women carrying intramural lesions (n= 80 couples). There was no significant relationship between clinical outcome and either the number or size of the fibroids.

CONCLUSIONS In asymptomatic patients selected for IVF, small fibroids not encroaching the endometrial cavity did not impact on the rate of success of the procedure.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (4): 834-839. doi: 10.1093/humrep/der015 First published online: February 11, 2011

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