McGill University Health Center, Montreal, Quebec, Canada.
McGill University Health Center, Montreal, Quebec, Canada.
J Minim Invasive Gynecol. 2018 Nov-Dec;25(7):1241-1248. doi: 10.1016/j.jmig.2018.03.005. Epub 2018 Mar 9.
To assess clinical pregnancy rate (CPR) and live birth rate (LBR) in the presence of non-cavity-deforming intramural myomas in single fresh blastocyst transfer cycles.
Retrospective cohort study (Canadian Task Force classification II-2).
Academic fertility center.
A total of 929 fresh single blastocyst transfer cycles were included, 94 with only non-cavity-distorting intramural myomas and 764 without myomas. Cleavage embryo transfers were excluded to reduce bias based on embryo quality.
None.
CPR and LBR were assessed. There were no differences noted in gravidity, parity, or body mass index between patients with myomas and those without myomas. Women with myomas required higher doses of gonadotropins (mean, 2653 ± 404 IU vs 2350 ± 1368 IU; p = .04) than women without myomas. However, the total number of mature oocytes collected and the total number of blastocysts created were similar. CPR (47% vs 32%; p = .005) and LBR (37.8% vs 25.5%; p = .02) were lower in patients who had intramural myomas compared with those without myomas. CPR and LBR were significantly reduced in the presence of even 1 myoma (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.33-0.83 and OR, 0.56; 95% CI, 0.35-0.92, respectively). In patients with myomas >1.5 cm, LBR was also significantly reduced, even after adjusting for age, smoking, quality of embryo transferred, antral follicle count, and dose of gonadotropins (OR, 0.53; 95% CI, 0.29-0.97). This LBR finding was not significant if all myomas were included (including those <1.5 cm in diameter), but CPR was still significantly reduced.
Relatively small (>1.5 cm) non-cavity-distorting intramural myomas negatively affect CPR and LBR in in vitro fertilization cycles, even in the presence of only 1 myoma.
评估在单个新鲜囊胚移植周期中存在非腔变形性子宫壁肌瘤时的临床妊娠率（CPR）和活产率（LBR）。
回顾性队列研究（加拿大任务组分类 II-2）。
学术生育中心。
共纳入 929 例新鲜单个囊胚移植周期，94 例仅存在非腔变形性子宫壁肌瘤，764 例无肌瘤。排除卵裂胚胎移植以减少基于胚胎质量的偏差。
无。
评估 CPR 和 LBR。肌瘤患者与无肌瘤患者的孕次、产次或体重指数无差异。有肌瘤的女性需要更高剂量的促性腺激素（平均值，2653±404 IU 比 2350±1368 IU；p=0.04）。然而，采集的成熟卵母细胞总数和形成的囊胚总数相似。与无肌瘤患者相比，有子宫壁肌瘤的患者 CPR（47%比 32%；p=0.005）和 LBR（37.8%比 25.5%；p=0.02）较低。即使存在 1 个肌瘤，CPR 和 LBR 也显著降低（优势比 [OR]，0.53；95%置信区间 [CI]，0.33-0.83 和 OR，0.56；95% CI，0.35-0.92）。在肌瘤 >1.5 cm 的患者中，即使调整年龄、吸烟、移植胚胎质量、窦卵泡计数和促性腺激素剂量后，LBR 也显著降低（OR，0.53；95% CI，0.29-0.97）。如果包括所有肌瘤（包括直径 <1.5 cm 的肌瘤），则这种 LBR 发现不显著，但 CPR 仍显著降低。
相对较小（>1.5 cm）的非腔变形性子宫壁肌瘤即使存在 1 个肌瘤也会对体外受精周期的 CPR 和 LBR 产生负面影响。
