Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Unit of Gynecologic Oncology, ARNAS "Civico - Di Cristina - Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
Int J Gynaecol Obstet. 2023 Nov;163(2):528-539. doi: 10.1002/ijgo.14838. Epub 2023 May 15.
The effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain.
To evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic review and meta-analysis (CRD42022379700).
Electronic databases were searched until November 15, 2022.
Studies evaluating the effects of FIGO type 3 myomas on IVF outcome.
Pooled results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using Higgins I . Sources of heterogeneity were explored with sensitivity and subgroup analyses.
In total, 1020 patients were included: 324 with FIGO type 3 myomas and 696 controls (without myomas). A pooled data analysis showed a significantly lower live birth rate (OR 2.16, 95% CI 1.55-3.01, I = 0%, P < 0.00001), clinical pregnancy rate (OR 2.06, 95% CI 1.52-2.81, I = 0%, P < 0.00001), and implantation rate (OR 1.77, 95% CI 1.35-2.32, I = 0%, P < 0.00001) in women with untreated myomas compared with controls. The number and size of fibroids correlated with a worsening of IVF outcomes.
FIGO type 3 myomas are significantly associated with a lower implantation rate, cumulative pregnancy rate, and live birth rate. Furthermore, their deleterious effect on the outcome of IVF increases further with increasing size and number. Nevertheless, no firm conclusions could be drawn about the potential benefits of surgery for FIGO type 3 uterine fibroids on IVF outcomes.
FIGO（国际妇产科联合会）3 型子宫肌瘤对体外受精（IVF）的影响尚不确定。
通过系统评价和荟萃分析（CRD42022379700）评估 FIGO 3 型子宫肌瘤是否影响 IVF 结局。
电子数据库检索截至 2022 年 11 月 15 日。
评估 FIGO 3 型子宫肌瘤对 IVF 结局影响的研究。
汇总结果表示为比值比（OR）及其 95%置信区间（CI）。采用 Higgins I 评估异质性，并通过敏感性和亚组分析探索异质性来源。
共纳入 1020 名患者：324 名患有 FIGO 3 型子宫肌瘤，696 名对照组（无子宫肌瘤）。荟萃分析显示，活产率显著降低（OR 2.16，95%CI 1.55-3.01，I²=0%，P<0.00001）、临床妊娠率（OR 2.06，95%CI 1.52-2.81，I²=0%，P<0.00001）和着床率（OR 1.77，95%CI 1.35-2.32，I²=0%，P<0.00001）均降低。肌瘤的数量和大小与 IVF 结局恶化相关。
FIGO 3 型子宫肌瘤与较低的着床率、累积妊娠率和活产率显著相关。此外，随着肌瘤大小和数量的增加，其对 IVF 结局的不良影响进一步增加。然而，对于 FIGO 3 型子宫肌瘤手术对 IVF 结局的潜在益处，仍无法得出明确结论。
