The impact of FIGO type 3 fibroids on in-vitro fertilization outcomes: A nested retrospective case-control study

Objective: To explore the impact of FIGO type 3 fibroids on the outcomes of in vitro fertilization (IVF) cycles.

Study design: This is a nested retrospective case-control study. Women with FIGO type 3 intramural fibroids, who underwent the first IVF cycle between January 2010 and December 2016 were included in the study as fibroids group. Patients in control group were randomly selected from a general IVF cohort by a ratio of 2:1 with fibroids group, matched by age, BMI, type and cause of infertility and antral follicle count. Implantation rate (IPR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR) were compared between groups.

Results: A total of 97 women comprised the fibroids group. Additional 194 women with normal uterus were included in the control group. While baseline characteristics did not differ between the groups, women with FIGO type 3 intramural fibroids showed significantly lower IPR (15.7 % vs. 24.6 %, p = 0.015), CPR (23.7 % vs. 38.1 %, p = 0.014) and LBR (16.5 % vs. 30.4 %, p = 0.011) compared with non-fibroid controls. No difference was observed in MR (p > 0.05). Fibroids of a maximum diameter ≥30 mm or multiple (≥2) fibroids decrease the IPR, CPR and LBR compared with the control group, while the smaller ones or single fibroid has no impact on IVF outcomes.

Conclusions: FIGO type 3 fibroid ≥30 mm or multiple fibroids might exert deleterious impact on implantation, clinical pregnancy and live birth rate of IVF cycles.