Ballesteros Manzo Alberto, Barros Delgadillo Juan Carlos, Ochoa Rueda Senia, Villalobos Acosta Sergio, Barroso Villa Gerardo, Sánchez Solís Victor, Gaviño Gaviño Fernando
Departamento de Reproducción Asistida, Instituto Nacional de Perinatología, Lomas Virreyes, México, DF.
Ginecol Obstet Mex. 2006 Jan;74(1):55-65.
To evaluate the effect of intramural and subserous myomas in in vitro fertilization cycles, as well as its perinatal results.
Cases and controls.
All the IVF cycles between October 1999 and December 2004 were included. The variables of size and type of myomas, as well as variables of IVF cycles, implantation and pregnancy rates, and perinatal results were analyzed. We calculated the chi-square test to analyze the relationship between myomas and pregnancy. The t-Student test was used to establish the difference in the average between both groups regarding the studied variables. In the logistic regression analysis we controlled confusing variables.
We analyzed 431 cycles made in 364 patients divided into two groups: study cases (with myomas-65 cycles) and control cases (without myomas-366 cycles). Age was two years older in the study group (35.7 vs 33.5, p < 0.001). There was no difference in: duration, type of infertility, days of stimulation, gonadotrophin dose, total and mature follicles, and fertilization and implantation rates. We only observed a difference in the recovered oocytes (8.0 vs 9.7, p = 0.027). The pregnancy, abortion and live-born children rates were of 20.0 vs 23.2, 46.1 vs 29.4, and 46.1 vs 58.8%, respectively (study and control groups; p > 0.05). Logistic regression showed that myomas do not affect the possibility of getting pregnant.
Intramural and subserous myomas < 5 cm do not seem to have an effect in the IVF cycles nor in its perinatal results. In women with myomas < 5 cm that no dot distortion the uterine cavity it is questionable the usefulness of a myomectomy prior to IVF cycles.
评估壁间肌瘤和浆膜下肌瘤对体外受精周期的影响及其围产期结局。
病例对照研究。
纳入1999年10月至2004年12月期间的所有体外受精周期。分析肌瘤的大小和类型变量，以及体外受精周期、着床率和妊娠率及围产期结局变量。计算卡方检验以分析肌瘤与妊娠之间的关系。采用t检验确定两组在研究变量平均值方面的差异。在逻辑回归分析中，我们控制了混杂变量。
我们分析了364例患者进行的431个周期，分为两组：研究病例组（有肌瘤-65个周期）和对照组（无肌瘤-366个周期）。研究组年龄比对照组大两岁（35.7岁对33.5岁，p<0.001）。在以下方面无差异：周期时长、不孕类型、刺激天数、促性腺激素剂量、总卵泡数和成熟卵泡数、受精率和着床率。我们仅观察到回收卵母细胞数量存在差异（8.0个对9.7个，p=0.027）。妊娠率、流产率和活产儿率分别为20.0%对23.2%、46.1%对29.4%和46.1%对58.8%（研究组和对照组；p>0.05）。逻辑回归显示肌瘤不影响妊娠可能性。
直径<5 cm的壁间肌瘤和浆膜下肌瘤似乎对体外受精周期及其围产期结局无影响。对于肌瘤直径<5 cm且未使子宫腔变形的女性，在体外受精周期前进行肌瘤切除术的实用性值得怀疑。
