Deger Ugur, Altinbas Ekin, Karabay Melis, Karatas Yagmur, Deniz Zeynep, Buyuker Ceyda, Yildirim Kopuk Sule, Tiras Bulent, Cakiroglu Yigit
Department of Obstetrics and Gynecology, Memorial Hospital, Diyarbakır, Turkey.
School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
J Obstet Gynaecol India. 2023 Aug;73(4):322-328. doi: 10.1007/s13224-023-01750-2. Epub 2023 Apr 24.
Uterine fibroids are the most common benign smooth muscle tumors of the uterus. However, there is no consensus on whether myomectomy improves IVF success in women with non-cavity-distorting intramural fibroids. The aim of this study was to compare the IVF and pregnancy outcomes of women who had non-cavity-distorting intramural fibroids and underwent myomectomy vs women who had intramural fibroids, but did not undergo myomectomy.
A retrospective cohort study at Acibadem Maslak Hospital, IVF Center, between 2019 and 2020. Data of 128 women aged between 25 and 43 years who have at least 2 intramural non-cavity-distorting fibroids of 2-6 cm in size were used. All patients had at least two IVF failure. The intervention group comprised women who decided to proceed to myomectomy before IVF (Group 1, = 56). The control group was established women with intramural fibroids who reject myomectomy (Group 2, = 71).
In regard to IVF result parameters and perinatal outcomes, there was no statistically significant difference between the two groups. Between study groups, there were no statistically significant differences in the perinatal outcomes. Myomectomy surgery did not increase miscarriage and biochemical pregnancy rate (odds ratio (OR) 0.9; 95% confidence interval (CI) 2.8-3.7).
Myomectomy does not impact on pregnancy or live birth rates substantially, according to the results of this study.
子宫肌瘤是子宫最常见的良性平滑肌肿瘤。然而，对于子宫肌瘤剔除术是否能提高非宫腔变形肌壁间肌瘤女性的体外受精成功率，目前尚无共识。本研究的目的是比较患有非宫腔变形肌壁间肌瘤并接受子宫肌瘤剔除术的女性与患有肌壁间肌瘤但未接受子宫肌瘤剔除术的女性的体外受精和妊娠结局。
2019年至2020年在阿西巴德马斯拉克医院体外受精中心进行一项回顾性队列研究。使用了128名年龄在25至43岁之间、至少有2个大小为2 - 6厘米的非宫腔变形肌壁间肌瘤的女性的数据。所有患者至少有两次体外受精失败经历。干预组包括在体外受精前决定进行子宫肌瘤剔除术的女性（第1组，n = 56）。对照组为拒绝子宫肌瘤剔除术的肌壁间肌瘤女性（第2组，n = 71）。
在体外受精结果参数和围产期结局方面，两组之间没有统计学上的显著差异。研究组之间围产期结局没有统计学上的显著差异。子宫肌瘤剔除术并未增加流产率和生化妊娠率（优势比（OR）0.9；95%置信区间（CI）2.8 - 3.7）。
根据本研究结果，子宫肌瘤剔除术对妊娠率或活产率没有实质性影响。
