EFFECT OF UTERINE LEIOMYOMATA ON THE RESULTS OF IN-VITRO FERTILIZATION TREATMENT

The effect of uterine leiomyoma on infertility is subject to controver sy. Two main mechanisms associating leiomyomata and infertility have b een suggested: the obstruction of gamete transport and impaired implan tation. In-vitro fertilization (IVF) is a unique setting for examining the effect of leiomyomata on the implantation rate. This study was de signed to determine the impact of uterine leiomyomata on the results o f IVF. In a retrospective analysis of IVF cycles, 46 women with docume nted uterine leiomyoma were compared with a control group with mechani cal infertility. The implantation rate and pregnancy outcome in relati on to the leiomyoma were observed. Implantation (22.1%/transfer, 6.8%/ embryo) and abortion rates (36%) in the study group were similar to th e results in the control group with pure mechanical factor. An analysi s of IVF results according to the hysteroscopic pretreatment findings revealed that impaired implantation is associated with leiomyoma only where uterine intracavitary abnormalities co-exist. We conclude that i mplantation rate and pregnancy outcome are impaired in women with uter ine leiomyomata only when they cause deformation of the uterine cavity . In patients with leiomyomata associated with an abnormal uterine cav ity, surgical treatment should be considered prior to IVF because of t he reduced implantation rate.