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Management of fibroids prior to in vitro fertilization/intracytoplasmic sperm injection: A pragmatic approach

Sarıdoğan, E; Sarıdoğan, E; (2019) Management of fibroids prior to in vitro fertilization/intracytoplasmic sperm injection: A pragmatic approach. Journal of the Turkish-German Gynecological Association , 20 (1) pp. 55-59. 10.4274/jtgga.galenos.2018.2018.0148. Green open access

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Abstract

Fibroids are relatively common in women undergoing in vitro fertilization (IVF) treatment due to their high prevalence in women. It is generally accepted that submucosal fibroids are deleterious to IVF outcomes and their removal is beneficial. Evidence from relatively low quality studies on the impact of intramural fibroids on IVF outcome is also suggestive of a detrimental impact. The majority of published studies included women with relatively small intramural fibroids and women with cavity-distorting fibroids were usually excluded, hence it is quite likely that the detected impact in the systematic reviews is an underestimation. Evidence of benefit is scarce for the removal of noncavity-distorting intramural fibroids. It is quite likely that numbers needed to treat for this purpose would be very high for small fibroids but lower for larger fibroids. This would need to be taken into account when decisions are made on myomectomy and potential benefits should be weighed against the associated morbidity, cost, and delay in fertility treatment. Whilst there is a need to perform prospective randomised studies in this field, a pragmatic approach that takes prognostic factors into account to estimate the magnitude of the possible impact of the fibroid(s) and potential benefit of removal is likely to lead to better reproductive outcomes.

Type: Article
Title: Management of fibroids prior to in vitro fertilization/intracytoplasmic sperm injection: A pragmatic approach
Location: Turkey
Open access status: An open access version is available from UCL Discovery
DOI: 10.4274/jtgga.galenos.2018.2018.0148
Publisher version: https://doi.org/10.4274/jtgga.galenos.2018.2018.01...
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Fibroids, leiomyoma, in vitro fertilization, assisted reproductive technology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health
URI: https://discovery.ucl.ac.uk/id/eprint/10108931
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