Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China.
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China.
Fertil Steril. 2014 Mar;101(3):716-21. doi: 10.1016/j.fertnstert.2013.11.023. Epub 2014 Jan 11.
To investigate the effect of fibroids that do not distort the endometrial cavity on IVF/intracytoplasmic sperm injection (ICSI) outcomes and to identify certain fibroid subgroups that may be deleterious to fertility outcomes.
Retrospective cohort study.
University-based reproductive medicine center.
PATIENT(S): A total of 10,268 patients undergoing IVF/ICSI between 2009 and 2011 in our unit.
INTERVENTION(S): Transvaginal ultrasound and hysteroscopy; controlled ovarian hyperstimulation and IVF/ICSI; strict matching criteria.
MAIN OUTCOME MEASURE(S): Cycle cancellation, clinical pregnancy, miscarriage, and delivery rates.
RESULT(S): We included 249 patients with fibroids who underwent IVF/ICSI. Higher day 3 FSH levels were found in women with fibroids compared with in control subjects. No significant differences were found in IVF/ICSI outcomes between the two groups. Patients with intramural fibroids with the largest diameter <2.85 cm or the sum of reported diameters <2.95 cm had a significantly higher delivery rate than patients with larger fibroids. A significant negative effect on delivery rate was noted when intramural fibroids with the largest diameter greater than 2.85 cm were considered, compared with matched controls without fibroids.
CONCLUSION(S): Our results suggest that although non-cavity-distorting fibroids do not affect IVF/ICSI outcomes, intramural fibroids greater than 2.85 cm in size significantly impair the delivery rate of patients undergoing IVF/ICSI.
探讨不改变子宫内膜腔的肌瘤对体外受精/卵胞浆内单精子注射（ICSI）结局的影响，并确定某些可能对生育结局有害的肌瘤亚组。
回顾性队列研究。
大学附属生殖医学中心。
我们单位在 2009 年至 2011 年间共进行了 10268 例 IVF/ICSI。
经阴道超声和宫腔镜；控制性卵巢超排卵和 IVF/ICSI；严格的匹配标准。
周期取消、临床妊娠、流产和分娩率。
我们纳入了 249 例接受 IVF/ICSI 的肌瘤患者。与对照组相比，肌瘤患者的第 3 天 FSH 水平更高。两组间 IVF/ICSI 结局无显著差异。与较大肌瘤患者相比，直径<2.85cm 的肌壁间肌瘤或报告直径总和<2.95cm 的肌壁间肌瘤患者的分娩率显著更高。当考虑最大直径大于 2.85cm 的肌壁间肌瘤时，对分娩率有显著的负面影响，与没有肌瘤的匹配对照组相比。
我们的结果表明，虽然非腔室变形肌瘤不影响 IVF/ICSI 结局，但直径大于 2.85cm 的肌壁间肌瘤显著损害接受 IVF/ICSI 的患者的分娩率。
