UTERINE LEIOMYOMAS REDUCE THE EFFICACY OF ASSISTED REPRODUCTION CYCLES - RESULTS OF A MATCHED FOLLOW-UP-STUDY

A matched follow-up study design was used to test the hypothesis that pregnancy rates following assisted reproduction procedures do not diff er between women with or without intramural or sub-serosal uterine lei omyomas. Women undergoing their first in-vitro fertilization (IVF)-emb ryo transfer or zygote intra-Fallopian transfer (ZIFT) cycle between J anuary 1993 and June 1995 were included, Cases (women with leiomyomas) were matched 1:1 with the next consecutive control (women without lei omyomas) according to age, number of embryos transferred, embryo grade , and the route of embryo transfer (uterine or Fallopian), Assisted re production cycles were performed in an identical manner, independent o f the presence or absence of uterine leiomyomas, The main outcomes mea sured were clinical pregnancy and delivery rates, A total of 182 cycle s was evaluated, Of the 91 assisted reproduction cycles performed in t he leiomyoma group, there were 34 clinical pregnancies (37%) and 30 de liveries (33%), Of the 91 assisted reproduction cycles in the control group, there were 48 clinical pregnancies (53%) and 44 deliveries (48% ), The Mantel-Haenszel estimate of relative risk indicated that the pr esence of a uterine leiomyoma significantly reduced the chance for a c linical pregnancy or delivery, These findings suggest that leiomyomas are associated with a reduction in the efficacy of assisted reproducti on cycles.