Fibroid removal may improve IVF results

The chances of pregnancy resulting from an assisted reproductive procedure such as in vitro fertilization are improved if the woman first has any significant fibroids removed, a new study suggests.

Dr. Eric S. Surrey, medical director of the Colorado Center for Reproductive Medicine in Englewood, said the findings show that this approach can "restore pregnancy rates to those what would be expected for women without fibroids at all."

Therefore saif, it's "absolutely critical" for women to be thoroughly evaluated for uterine fibroids before they undergo assisted reproductive procedure.

Some studies have suggested that at least some women with fibroids who undergo fertility treatment have impaired pregnancy and implantation rates, Surrey and his colleagues note in the journal Fertility and Sterility.

"It is logical to assume that removing these tumors would be beneficial, but this has not been previously shown," Surrey said.

To investigate further, his team evaluated 101 women who were planning in vitro fertilization with either their own eggs or donor eggs and who had fibroids distorting or impinging upon the cavity of the uterus. These tumors were removed prior to the IVF procedure.

When the researchers compared outcomes in these women with a group of similar but fibroid-free women, "we noted that ongoing pregnancy and implantation rates were the same after surgery as they were for women who did not have fibroids at all," Surrey said.

He and his colleagues conclude that the result of fertility procedures "appears to be enhanced by judicious resection of those lesions that are most likely to exert a negative effect" - but they'd like to see a clinical trial conducted to "provide definitive answers."

SOURCE: Fertility and Sterility, May 2005.