Advertisement

The impact of FIGO type 3 fibroids on in-vitro fertilization outcomes: A nested retrospective case-control study

  • Author Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Xi Bai
    Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Affiliations
    Department of Obstetrics and Gynecology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
    Search for articles by this author
  • Author Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Yihua Lin
    Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China

    Key Laboratory of Assisted Reproduction(Peking University), Ministry of Education, Beijing, 100191, China
    Search for articles by this author
  • Author Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Yanrong Chen
    Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China

    Key Laboratory of Assisted Reproduction(Peking University), Ministry of Education, Beijing, 100191, China
    Search for articles by this author
  • Caihong Ma
    Correspondence
    Corresponding author at: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China

    Key Laboratory of Assisted Reproduction(Peking University), Ministry of Education, Beijing, 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
    Search for articles by this author
  • Author Footnotes
    1 Xi Bai, Yihua Lin and Yanrong Chen contributed equally to this work.
Published:February 18, 2020DOI:https://doi.org/10.1016/j.ejogrb.2019.12.018

      Abstract

      Objective

      To explore the impact of FIGO type 3 fibroids on the outcomes of in vitro fertilization (IVF) cycles.

      Study design

      This is a nested retrospective case-control study. Women with FIGO type 3 intramural fibroids, who underwent the first IVF cycle between January 2010 and December 2016 were included in the study as fibroids group. Patients in control group were randomly selected from a general IVF cohort by a ratio of 2:1 with fibroids group, matched by age, BMI, type and cause of infertility and antral follicle count. Implantation rate (IPR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR) were compared between groups.

      Results

      A total of 97 women comprised the fibroids group. Additional 194 women with normal uterus were included in the control group. While baseline characteristics did not differ between the groups, women with FIGO type 3 intramural fibroids showed significantly lower IPR (15.7 % vs. 24.6 %, p = 0.015), CPR (23.7 % vs. 38.1 %, p = 0.014) and LBR (16.5 % vs. 30.4 %, p = 0.011) compared with non-fibroid controls. No difference was observed in MR (p > 0.05). Fibroids of a maximum diameter ≥30 mm or multiple (≥2) fibroids decrease the IPR, CPR and LBR compared with the control group, while the smaller ones or single fibroid has no impact on IVF outcomes.

      Conclusions

      FIGO type 3 fibroid ≥30 mm or multiple fibroids might exert deleterious impact on implantation, clinical pregnancy and live birth rate of IVF cycles.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Bajekal N.
        • Li T.C.
        Fibroids, infertility and pregnancy wastage.
        Hum Reprod Update. 2000; 6: 614-620
        • Zepiridis L.I.
        • Grimbizis G.F.
        • Tarlatzis B.C.
        Infertility and uterine fibroids.
        Best Pract Res Clin Obstet Gynaecol. 2016; 34: 66-73
        • Pritts E.A.
        • Parker W.H.
        • Olive D.L.
        Fibroids and infertility: an updated systematic review of the evidence.
        Fertil Steril. 2009; 91: 1215-1223
        • Thompson M.J.
        • Carr B.R.
        Intramural myomas: to treat or not to treat.
        Int J Womens Health. 2016; 8: 145-149
        • Behbehani S.
        • Polesello S.
        • Hasson J.
        • Silver J.
        • Son W.Y.
        • Dahan M.
        The Effect of Intramural Myomas Without an Intracavity Component on In Vitro Fertilization Outcomes in Single Fresh Blastocyst Transfer Cycles.
        J Minim Invasive Gynecol. 2018; 25: 1241-1248
        • Christopoulos G.
        • Vlismas A.
        • Salim R.
        • Islam R.
        • Trew G.
        • Lavery S.
        Fibroids that do not distort the uterine cavity and IVF success rates: an observational study using extensive matching criteria.
        BJOG. 2017; 124: 615-621
        • Guven S.
        • Kart C.
        • Unsal M.A.
        • Odaci E.
        Intramural leoimyoma without endometrial cavity distortion may negatively affect the ICSI - ET outcome.
        Reprod Biol Endocrinol. 2013; 11: 102
        • Sunkara S.K.
        • Khairy M.
        • El-Toukhy T.
        • Khalaf Y.
        • Coomarasamy A.
        The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis.
        Hum Reprod. 2010; 25: 418-429
        • Somigliana E.
        • De Benedictis S.
        • Vercellini P.
        • et al.
        Fibroids not encroaching the endometrial cavity and IVF success rate: a prospective study.
        Hum Reprod. 2011; 26: 834-839
        • Styer A.K.
        • Jin S.
        • Liu D.
        • et al.
        Association of uterine fibroids and pregnancy outcomes after ovarian stimulation-intrauterine insemination for unexplained infertility.
        Fertil Steril. 2017; 107 (e3): 756-762
        • Yan L.
        • Ding L.
        • Li C.
        • Wang Y.
        • Tang R.
        • Chen Z.J.
        Effect of fibroids not distorting the endometrial cavity on the outcome of in vitro fertilization treatment: a retrospective cohort study.
        Fertil Steril. 2014; 101: 716-721
        • Wang X.
        • Chen L.
        • Wang H.
        • Li Q.
        • Liu X.
        • Qi H.
        The Impact of Noncavity-Distorting Intramural Fibroids on the Efficacy of In Vitro Fertilization-Embryo Transfer: An Updated Meta-Analysis.
        Biomed Res Int. 2018; 20188924703
        • Levine D.J.
        • Berman J.M.
        • Harris M.
        • Chudnoff S.G.
        • Whaley F.S.
        • Palmer S.L.
        Sensitivity of myoma imaging using laparoscopic ultrasound compared with magnetic resonance imaging and transvaginal ultrasound.
        J Minim Invasive Gynecol. 2013; 20: 770-774
        • Munro M.G.
        • Critchley H.O.
        • Broder M.S.
        • Fraser I.S.
        FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age.
        Int J Gynaecol Obstet. 2011; 113: 3-13
        • Yan L.
        • Yu Q.
        • Zhang Y.N.
        • et al.
        Effect of type 3 intramural fibroids on in vitro fertilization-intracytoplasmic sperm injection outcomes: a retrospective cohort study.
        Fertil Steril. 2018; 109817-822.e2
        • Lu N.
        • Wang Y.
        • Su Y.C.
        • Sun Y.P.
        • Guo Y.H.
        Effects of the distance between small intramural uterine fibroids and the endometrium on the pregnancy outcomes of in vitro fertilization-embryo transfer.
        Gynecol Obstet Invest. 2015; 79: 62-68
        • Oliveira F.G.
        • Abdelmassih V.G.
        • Diamond M.P.
        • Dozortsev D.
        • Melo N.R.
        • Abdelmassih R.
        Impact of subserosal and intramural uterine fibroids that do not distort the endometrial cavity on the outcome of in vitro fertilization-intracytoplasmic sperm injection.
        Fertil Steril. 2004; 81: 582-587