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01-02-2017 | Gynecologic Endocrinology and Reproductive Medicine

Pregnancy outcomes in oocyte recipients with fibroids not impinging uterine cavity

Authors: Lena Sagi-Dain, Kamal Ojha, David Bider, Jacob Levron, Viktor Zinchenko, Sharon Walster, Shlomi Sagi, Martha Dirnfeld

Published in: Archives of Gynecology and Obstetrics | Issue 2/2017

Abstract

Objective

To examine the effects of fibroid uterus on pregnancy outcomes and endometrial features in ovum donation recipients.

Methods

Retrospective analysis of 744 ovum donation cycles was conducted in two private IVF centers between 2005 and 2012. All the recipients underwent transvaginal ultrasound examination, including endometrial thickness and grade measurements. Clinical pregnancy, spontaneous miscarriage, and live birth rates were regarded as the primary outcomes.

Results

Leimyomas not distorting the uterine cavity were diagnosed in 264 (35.5%) of the cycles. This group exhibited lower endometrial thickness (8.33 ± 1.8 vs. 8.73 ± 2.03 mm, p = 0.009), lower rates of Grade A (16.1 vs. 30.1%, p < 0.0001), and higher rates of grade C endometrium (10.2 vs. 5.5%, p < 0.0001), compared to the group with sonographically normal uterine cavity. In addition, significantly higher spontaneous miscarriage rates were found in fibroid uteri group (25 vs. 14.5%, p = 0.036).

Conclusion

Our study results suggest that uterine fibroids not distorting the uterine cavity could constitute a risk factor for spontaneous miscarriage in oocyte donation cycles, possibly via their adverse effect on endometrial receptivity. Further well-designed trials should widely explore this subject, particularly focusing on impact of myomectomy on fertility rates in these patients.

Baird DD et al (2003) High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 188(1):100–107CrossRefPubMed

Olive DL, Pritts EA (2010) Fibroids and reproduction. Semin Reprod Med 28(3):218–227CrossRefPubMed

Oliveira FG et al (2004) Impact of subserosal and intramural uterine fibroids that do not distort the endometrial cavity on the outcome of in vitro fertilization-intracytoplasmic sperm injection. Fertil Steril 81(3):582–587CrossRefPubMed

Pritts EA, Parker WH, Olive DL (2009) Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 91(4):1215–1223CrossRefPubMed

Sunkara SK et al (2010) The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis. Hum Reprod 25(2):418–429CrossRefPubMed

Levens ED et al (2008) Ultrasonographic characteristics of the endometrium among patients with fibroids undergoing ART. Fertil Steril 89(4):1005–1007CrossRefPubMed

Hart R et al (2001) A prospective controlled study of the effect of intramural uterine fibroids on the outcome of assisted conception. Hum Reprod 16(11):2411–2417PubMed

Yan L et al (2014) Effect of fibroids not distorting the endometrial cavity on the outcome of in vitro fertilization treatment: a retrospective cohort study. Fertil Steril 101(3):716–721CrossRefPubMed

Klatsky PC et al (2007) The effect of fibroids without cavity involvement on ART outcomes independent of ovarian age. Hum Reprod 22(2):521–526CrossRefPubMed

10.

Horcajadas JA et al (2008) Endometrial receptivity and implantation are not affected by the presence of uterine intramural leiomyomas: a clinical and functional genomics analysis. J Clin Endocrinol Metab 93(9):3490–3498CrossRefPubMed

11.

Pellicer A et al (1989) Ovarian response and outcome of in vitro fertilization in patients treated with gonadotrophin-releasing hormone analogues in different phases of the menstrual cycle. Hum Reprod 4(3):285–289PubMed

12.

Remohi J et al (1995) Long oestradiol replacement in an oocyte donation programme. Hum Reprod 10(6):1387–1391CrossRefPubMed

13.

Barker MA et al (2009) Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles. J Assist Reprod Genet 26(5):243–249CrossRefPubMedPubMedCentral

14.

Zhang X et al (2005) Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 83(2):336–340CrossRefPubMed

15.

Yuval Y et al (1999) The relationships between endometrial thickness, and blood flow and pregnancy rates in in vitro fertilization. Hum Reprod 14(4):1067–1071CrossRefPubMed

16.

Dain L et al (2013) Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril 100(5):1289–1295CrossRefPubMed

17.

Sher G et al (1991) Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in vitro fertilization and embryo transfer (IVF/ET). Hum Reprod 6(2):232–237PubMed

18.

Puerto B et al (2003) Ultrasonography as a predictor of embryo implantation after in vitro fertilization: a controlled study. Fertil Steril 79(4):1015–1022CrossRefPubMed

19.

Sharara FI, Lim J, McClamrock HD (1999) Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet 16(10):523–528CrossRefPubMedPubMedCentral

20.

Kurjak A, Kupesic-Urek S, Miric D (1992) The assessment of benign uterine tumor vascularization by transvaginal color Doppler. Ultrasound Med Biol 18(6–7):645–649CrossRefPubMed

21.

Ng EH et al (2005) Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment. Hum Reprod 20(2):501–506CrossRefPubMed

22.

Rackow BW, Taylor HS (2010) Submucosal uterine leiomyomas have a global effect on molecular determinants of endometrial receptivity. Fertil Steril 93(6):2027–2034CrossRefPubMed

23.

Matsuzaki S et al (2009) HOXA-10 expression in the mid-secretory endometrium of infertile patients with either endometriosis, uterine fibromas or unexplained infertility. Hum Reprod 24(12):3180–3187CrossRefPubMed

24.

Sinclair DC, Mastroyannis A, Taylor HS (2011) Leiomyoma simultaneously impair endometrial BMP-2-mediated decidualization and anticoagulant expression through secretion of TGF-beta3. J Clin Endocrinol Metab 96(2):412–421CrossRefPubMed

25.

Matsuzaki S et al (2010) Impaired down-regulation of E-cadherin and beta-catenin protein expression in endometrial epithelial cells in the mid-secretory endometrium of infertile patients with endometriosis. J Clin Endocrinol Metab 95(7):3437–3445CrossRefPubMed

26.

Kang JL et al (2010) Up-regulation of apoptosis by gonadotrophin-releasing hormone agonist in cultures of endometrial cells from women with symptomatic myomas. Hum Reprod 25(9):2270–2275CrossRefPubMed

27.

Ferraretti AP et al (2013) Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod 28(9):2318–2331CrossRefPubMed

28.

Kupka MS et al (2014) Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHREdagger. Hum Reprod 29(10):2099–2113CrossRefPubMed

29.

Nyboe Andersen A et al (2009) Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE: ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod 24(6):1267–1287CrossRefPubMed

30.

Klonoff-Cohen HS, Natarajan L (2004) The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer. Am J Obstet Gynecol 191(2):507–514CrossRefPubMed

31.

Dain L, Auslander R, Dirnfeld M (2011) The effect of paternal age on assisted reproduction outcome. Fertili Steril 95(1):1–8CrossRef

32.

Donnez J, Dolmans M-M (2016) Uterine fibroid management: from the present to the future. Hum Reprod Update 22(6):665–686CrossRefPubMed

Title: Pregnancy outcomes in oocyte recipients with fibroids not impinging uterine cavity
Authors: Lena Sagi-Dain
Kamal Ojha
David Bider
Jacob Levron
Viktor Zinchenko
Sharon Walster
Shlomi Sagi
Martha Dirnfeld
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4273-9

2024 ASCO Annual Meeting

Springer Medicine

Pregnancy outcomes in oocyte recipients with fibroids not impinging uterine cavity

Abstract

Objective

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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