Assisted Conception Unit, Guy's and St Thomas' Hospitals NHS Foundation Trust, 11th Floor, Tower Wing, Guy's Hospital Great Maze Pond, London SE1 9RT, UK.
Hum Reprod. 2010 Feb;25(2):418-29. doi: 10.1093/humrep/dep396. Epub 2009 Nov 12.
The influence of fibroids on fertility is poorly understood. Submucosal and intramural fibroids that distort the endometrial cavity have been associated with decreased pregnancy rates (PRs) following IVF treatment. However, there is uncertainty about the effect of intramural fibroids that do not distort the endometrial cavity on IVF outcomes.
We conducted a systematic review and meta-analysis of studies to evaluate the association between non-cavity-distorting intramural fibroids and IVF outcome. Searches were conducted on MEDLINE, EMBASE, Cochrane Library and Web of Science. Study selection and data extraction were conducted independently by two reviewers. The Newcastle-Ottawa Quality Assessment Scales were used for quality assessment. Meta-analysis was performed if appropriate.
We identified 19 observational studies comprising 6087 IVF cycles. Meta-analysis of these studies showed a significant decrease in the live birth (RR = 0.79, 95% CI: 0.70-0.88, P < 0.0001) and clinical PRs (RR = 0.85, 95% CI: 0.77-0.94, P = 0.002) in women with non-cavity-distorting intramural fibroids compared with those without fibroids, following IVF treatment.
The presence of non-cavity-distorting intramural fibroids is associated with adverse pregnancy outcomes in women undergoing IVF treatment.
子宫肌瘤对生育能力的影响尚未被充分了解。黏膜下和肌壁内肌瘤使子宫内膜腔变形，与 IVF 治疗后的妊娠率（PR）降低有关。然而，对于不使子宫内膜腔变形的肌壁内肌瘤对 IVF 结局的影响尚存在不确定性。
我们对评估非变形性肌壁内肌瘤与 IVF 结局之间关系的研究进行了系统评价和荟萃分析。在 MEDLINE、EMBASE、Cochrane 图书馆和 Web of Science 上进行了检索。两名评审员独立进行了研究选择和数据提取。使用纽卡斯尔-渥太华质量评估量表进行质量评估。如果合适，进行荟萃分析。
我们确定了 19 项观察性研究，共包含 6087 个 IVF 周期。对这些研究的荟萃分析表明，与无肌瘤的妇女相比，患有非变形性肌壁内肌瘤的妇女的活产（RR = 0.79，95%CI：0.70-0.88，P < 0.0001）和临床 PR（RR = 0.85，95%CI：0.77-0.94，P = 0.002）显著降低。
非变形性肌壁内肌瘤的存在与接受 IVF 治疗的妇女的不良妊娠结局有关。
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