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Hum. Reprod. Advance Access originally published online on September 22, 2006
Human Reproduction 2007 22(2):521-526; doi:10.1093/humrep/del370
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© The Author 2006. 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@oxfordjournals.org

The effect of fibroids without cavity involvement on ART outcomes independent of ovarian age

P.C. Klatsky1,4, D.E. Lane2, I.P. Ryan3 and V.Y. Fujimoto1

1 Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco 2 Kaiser Center for Reproductive Health, Vacaville and 3 Pacific Fertility Center, San Francisco, CA, USA

4 To whom correspondence should be addressed at: Department of Obstetrics/Gynecology, University of California, San Francisco, 513 Parnassus Avenue, Box 0132, San Francisco, CA 94143, USA. E-mail: klatskyp{at}ucsf.obgyn.edu

BACKGROUND: The effect of fibroids that do not distort the endometrial cavity on pregnancy rate (PR) and implantation rate (IR) is controversial. Use of oocyte donor-derived embryos offers an ideal patient population to study the effect of fibroids in patients utilizing assisted reproductive technologies (ARTs). METHODS: We conducted a retrospective cohort study of patients undergoing oocyte donor recipient (ODR) IVF cycles at two tertiary care fertility centres. We examined medical records for the presence of non-cavity-distorting fibroids and evaluated subsequent PR and IR. RESULTS: Three hundred and sixty-nine patients, 94 with fibroids, underwent oocyte donor recipient transfer cycles with fresh embryos. There was no statistical difference in IR (36 versus 38%) or clinical PR (47 versus 54%) between patients with or without fibroids. Neither the location (subserosal versus intramural) and the presence of multiple myomas nor the size of the myomas affected outcomes. Fibroids were more likely to be present in patients with increasing recipient age. CONCLUSIONS: Clinical PR and IR are not affected by the presence of non-cavity-distorting leiomyomata. This evidence does not support myomectomy before ART in patients with asymptomatic fibroids that do not significantly distort the endometrial cavity or cause abnormal uterine bleeding.

Key words: ART/fibroid/myoma/oocyte donor


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