AN OPEN STUDY OF LUTEINIZING-HORMONE-RELEASING HORMONE AGONISTS IN INFERTILE WOMEN WITH UTERINE FIBROIDS

Twenty infertile women with fibroids were treated with luteinizing hor mone releasing hormone agonists (LHRHa) to investigate if the use of t hese drugs, both with and without myomectomy, was effective in contrib uting to pregnancy in these women. All women had fibroids as their sol e cause for infertility. Seven women conceived within 1 year of myomec tomy or LHRHa treatment alone without myomectomy. The overall pregnanc y rate was 36% and the postmyomectomy pregnancy rate was 50%. Initial fibroid size and extent of fibroid shrinkage on LHRHa therapy made no difference to the subsequent pregnancy rate. We also found no signific ant interaction between the number of fibroids present and the effect of myomectomy on the proportion of pregnancies. We conclude that the f ertility enhancing value of myomectomy in otherwise idiopathic inferti lity is confirmed, and that the use of LHRHa premyomectomy in infertil e women needs to be investigated in randomized controlled trials to as sess its value as a preoperative therapy.