Benecke C, Kruger T F, Siebert T I, Van der Merwe J P, Steyn D W
Reproductive Biology Unit, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa.
Gynecol Obstet Invest. 2005;59(4):225-30. doi: 10.1159/000084513. Epub 2005 Mar 15.
The aim of this study is to evaluate the current data to understand the impact of intramural leiomyomata on pregnancy outcome in assisted reproduction.
In this review, articles were found by means of computerized Medline and Cochrane Library search using the key words uterine myomata, leiomyomata, fibroids, implantation, pregnancy, infertility and in vitro fertilization. Limitations were English, human, 1990-2002. Inclusion criteria were pregnancy data on in vitro fertilization, intramural myomata with no cavitary distortion and control groups without myomas for each patient with a myoma.
There was a significant negative impact on implantation rate in the intramural myomata groups versus the control groups, 16.4 vs. 27.7% OR 0.62 (0.48-0.8). The delivery rate per transfer cycle was also significantly lower (myomata vs. control), 31.2 vs. 40.9% OR 0.69 (0.50-0.95).
Our study supports the notion that patients with intramural fibroids have a lower implantation rate per cycle. The studies did not shed new light on the size of intramural myomata that could affect the outcome. In previous failed in vitro fertilization cycles, microsurgical removal of myomata must be considered.
本研究旨在评估现有数据，以了解壁间平滑肌瘤对辅助生殖中妊娠结局的影响。
在本综述中，通过计算机检索Medline和Cochrane图书馆，使用关键词子宫肌瘤、平滑肌瘤、纤维瘤、着床、妊娠、不孕症和体外受精来查找文章。限制条件为英文文献、人类研究、1990年至2002年。纳入标准为体外受精的妊娠数据、无腔变形的壁间肌瘤以及为每例有肌瘤患者设立的无肌瘤对照组。
壁间肌瘤组与对照组相比，着床率有显著负面影响，分别为16.4%和27.7%，比值比为0.62（0.48 - 0.8）。每个移植周期的分娩率也显著较低（肌瘤组与对照组），分别为31.2%和40.9%，比值比为0.69（0.50 - 0.95）。
我们的研究支持壁间肌瘤患者每个周期着床率较低的观点。这些研究并未揭示可能影响结局的壁间肌瘤大小的新情况。在先前体外受精失败的周期中，必须考虑对肌瘤进行显微手术切除。
