Human Reproduction, Vol 13, 198-202, Copyright © 1998 by Oxford University Press
AM Ramzy, M Sattar, Y Amin, RT Mansour, GI Serour and MA Aboulghar
The aim of this work was to study the effect of uterine myomata on the
implantation rate and outcome in in-vitro fertilization (IVF) and
intracytoplasmic sperm injection (ICSI). Among 406 patients, 51 (12.6%)
were found to have uterine corporeal myomata. Twelve patients were excluded
from the study as they had large myomata, submucous myomata or intramural
myomata encroaching on the cavity. These patients were advised to have
myomectomy before being enrolled in the IVF/ICSI programme. The remaining
patients (n = 39) were sorted according to the number, site and size of the
myomata as assessed by transvaginal sonography. Three patients had more
than one myoma. Most of the myomata were subserous (72.7%) and the mean
diameter of the myomata was 3.5 +/- 0.9 cm. A control group (n = 367) was
chosen with normal uteri and no history of uterine reconstruction surgery.
The mean age of myoma patients was 34.7 +/- 3.6 years as compared to 34.0
+/- 4.4 years in the control group. The age, period of infertility, body
mass index, duration and number of human menopausal gonadotrophin ampoules
needed for stimulation, oestradiol levels, number of oocytes retrieved and
the fertilization rate were not significantly different in the myoma
patients compared to the control group. Fifteen myoma patients (38.5%)
subsequently showed one or more pregnancy sacs on ultrasonography of which
three (20%) spontaneously aborted during the first trimester and two
(13.3%) had preterm labour, as compared to 123 (33.5%), 19 (15.5%) and nine
(7.3%) respectively, among the control group (P = 0.27, 0.33 and 0.21). In
conclusion, uterine corporeal myomata, not encroaching on the cavity and
<7 cm in mean diameter, do not affect the implantation or miscarriage
rates in IVF or ICSI.
ARTICLES
Uterine myomata and outcome of assisted reproduction
The Egyptian IVF-ET Centre, Department of Obstetrics and Gynaecology, Cairo University, Egypt.
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