Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
22B - Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
Against
from Section III - The Best Policy
Published online by Cambridge University Press: 25 November 2021
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
Summary
The evidence regarding intramural fibroids and fertility treatment outcomes is highly controversial and the evidence is significantly compromised by heterogeneity caused by a lack of clear definition of the size and number of intramural fibroids and their proximity to the endometrium as well as the presence of other types of fibroids and individual confounding variables. Furthermore, there is a lack of evidence that surgical removal of intramural fibroids would benefit fertility treatment. Until definitive evidence is available, surgical removal of intramural fibroids of 4cm or more is unjustified.
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 120 - 121Publisher: Cambridge University PressPrint publication year: 2021
References
Pritts, EA, Parker, WH, Olive, DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009;91:1215–23.CrossRefGoogle ScholarPubMed
Sunkara, SK, Khairy, M, El-Toukhy, T, Khalaf, Y, Coomarasamy, A. The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis. Hum Reprod. 2010;25:418–29.CrossRefGoogle ScholarPubMed
Donnez, J, Jadoul, P. What are the implications of myomas on fertility? A need for a debate?Hum Reprod. 2002;17:1424–30.CrossRefGoogle ScholarPubMed
Metwally, M, Farquhar, CM, Li, TC. Is another meta-analysis on the effects of intramural fibroids on reproductive outcomes needed? Reprod Biomed. 2011;23:2–14.CrossRefGoogle ScholarPubMed
Wang, X, Chen, L, Wang, H, Li, Q, Liu, X, Qi, H. The impact of noncavity-distorting intramural fibroids on the efficacy of in vitro fertilization-embryo transfer: an updated meta-analysis. Biomed Res Int. 2018;2018:8924703.Google ScholarPubMed