Human Reproduction Update, Vol.6, No.6 pp.614-620, 2000
© European Society of Human Reproduction and Embryology 2000; all rights reserved
Fibroids, infertility and pregnancy wastage
1 Reproductive Medicine & Surgery Unit, Jessop Hospital for Women, Leavygreave Road, Sheffield S3 7RE, UK
To whom correspondence should be addressed at: T. C. Li, Reproductive Medicine & Surgery Unit, Jessop Hospital for Women, Leavygreave Road, Sheffield S3 7RE, UK. Phone: +44 0114 226 8293; Fax: +44 0114 275 5467; e-mail: Tin.Chin.Li{at}sheffield.ac.uk
Abstract
Uterine fibroids are often found in women of reproductive age. Different types of fibroids may affect reproductive outcome to a different extent, with submucous, intramural and subserosal fibroids being (in decreasing order of importance) a cause of infertility and pregnancy wastage. Fibroids may also produce a number of complications during pregnancy. Women who are scheduled for assisted conception should be advised to have submucous and possibly intramural fibroids removed prior to IVF. Large fibroids (>5 cm), wherever their location, should be considered individually, with the reproductive history being an important consideration. Miscarriage rates are significantly reduced following myomectomy. Open myomectomy should be the route of choice when there are large subserosal or intramural fibroids, multiple fibroids or entry into the uterine cavity is to be expected. Proper assessment of the benefits and risks of surgery for individual patients should be carefully considered before offering a procedure.
Key words: assisted reproduction / fibroids / infertility / myomectomy / reproductive outcome
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