Human Reproduction, Vol 13, 192-197, Copyright © 1998 by Oxford University Press
DW Stovall, SB Parrish, BJ Van Voorhis, SJ Hahn, AE Sparks and CH Syrop
A matched follow-up study design was used to test the hypothesis that
pregnancy rates following assisted reproduction procedures do not differ
between women with or without intramural or sub-serosal uterine leiomyomas.
Women undergoing their first in-vitro fertilization (IVF)- embryo transfer
or zygote intra-Fallopian transfer (ZIFT) cycle between January 1993 and
June 1995 were included. Cases (women with leiomyomas) were matched 1:1
with the next consecutive control (women without leiomyomas) according to
age, number of embryos transferred, embryo grade, and the route of embryo
transfer (uterine or Fallopian). Assisted reproduction cycles were
performed in an identical manner, independent of the presence or absence of
uterine leiomyomas. The main outcomes measured were clinical pregnancy and
delivery rates. A total of 182 cycles was evaluated. Of the 91 assisted
reproduction cycles performed in the leiomyoma group, there were 34
clinical pregnancies (37%) and 30 deliveries (33%). Of the 91 assisted
reproduction cycles in the control group, there were 48 clinical
pregnancies (53%) and 44 deliveries (48%). The Mantel-Haenszel estimate of
relative risk indicated that the presence of a uterine leiomyoma
significantly reduced the chance for a clinical pregnancy or delivery.
These findings suggest that leiomyomas are associated with a reduction in
the efficacy of assisted reproduction cycles.
ARTICLES
Uterine leiomyomas reduce the efficacy of assisted reproduction cycles: results of a matched follow-up study
Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City 52242-1080, USA.
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