Title: Fibroids not encroaching the endometrial cavity and IVF success rate: a prospective study.
Journal: Human Reproduction. 2011;26:834-9.
Authors: Somigliana E, De Benedictis S, Vercellini P, Nicolosi AE, Benaglia L, Scarduelli C, Ragni G, Fedele L.
Study from: Department of Obset/Gynecol-Fondazione Cà Granda, Milano, Italy.
Problem: Other studies show that fibroids that bulge into the uterine cavity (submucous) decrease fertility and removal of these fibroids increases fertility. Fibroids outside the uterine wall do not influence fertility. Although some studies show a small decrease in fertility for fibroids within the uterine wall (intramural) other studies show no change in fertility. This study compared the rate of success of in vitro fertilization (IVF) in women with and without intramural fibroids smaller than 5 cm diameter (2”).
Study: Women with intramural fibroids with a diameter below 5 cm who needed IVF were compared to similar women without fibroids also having IVF
Results: There was no difference in the number of pregnancies and healthy deliveries between the 80 women with intramural fibroids less than 5 cm and the 119 women without fibroids.
Authors’ Conclusions: In patients selected for IVF, small fibroids not encroaching the endometrial cavity did not impact on the rate of success of the procedure.
Dr. Parker’s Comments: This study adds to other studies that show no decreased fertility in women with medium size fibroids within the wall, but not bulging into the cavity, of the uterus. The benefit of studies using IVF is that all the other factors that might influence fertility are minimize during IVF. Each of the fertility studies to date, including this one, have included only a small number of women. But, when added all together, the studies demonstrate that neither surgery, UAE nor focused ultrasound treatment is needed for these women before they try to conceive.
