Impact of uterine fibroids that do not alter uterine cavity morphology on the pregnancy outcome of patients with recurrent implantation failure
Objective To investigate whether intramural fibroids that do not distort the uterine cavity adversely affect the reproductive outcomes of frozen-thawed embryo transfer(FET)cycles in patients with recurrent implantation failure(RIF).Methods A ambispective cohort study analyzed data from patients diagnosed with RIF undergoing their first FET cycle at Reproductive Medicine Center,Obstetrics and Gynecology,Peking University Third Hospital,from January 1,2018 to December 12,2023.Patients were categorized into case group(fibroid patients,n=457)and control group(non-fibroid patients,n=1 693)based on whether they had intramural fibroids that did not distort the uterine cavity[type 3-6 according to 2011 International Federation of Obstetrics and Gynecology(FIGO)classification].Propensity score matching was performed(1∶2 ratio)using SPSS27.0 to adjust for age,endometrial thickness,cycle type,and embryo type.After matching,there were 857 cases in control group.Pregnancy outcomes including clinical pregnancy rate,human chorionic gonadotropin(hCG)positive rate,and early miscarriage rate were compared between the two groups.Subgroup analyses were conducted in the case group based on characteristics such as number,size,and location of the fibroids to study their impact on the outcomes of FET cycles.Results In patients with RIF undergoing FET cycles,there were no statistically significant differences between case group and the matched control group in terms of clinical pregnancy rate,early miscarriage rate,and hCG positive rate(all P>0.05).Within the fibroid patients,however,fibroids with a maximum diameter≥2 cm and<4 cm were associated with lower clinical pregnancy rate(OR=0.441,95%CI:0.218-0.891,a OR=0.408,P=0.022)and lower hCG positive rate(OR=0.374,95%CI:0.185-0.757,a OR=0.337,P=0.006)compared with the other sizes of intramural fibroids.Conclusion Type 3-6 intramural fibroids according to the FIGO classification do not affect the outcomes of FET cycles in patients with RIF.Additionally,the number and location of fibroids also do not affect reproductive outcomes.However,intramural fibroids with a diameter between 2-4 cm may potentially have adverse effects on embryo implantation compared with other sizes of intramural fibroids.
NETL
NSTL
万方数据
