Results of infertility treatment using assisted reproductive technology programs in patients with uterine fibroids

Abstract

DOI: 10.52705/2788-6190-2026-02-11
УДК 618.177-089.888-06:618.14-006.36-036.8

The objective: to evaluate the results of infertility treatment using assisted reproductive technologies in patients with uterine fibroids.
Materials and methods. The results of surgical treatment (disease recurrence, realization of reproductive function, course of pregnancy) were monitored for a period of up to 2 years after myomectomy in 510 patients with uterine fibroids. Patients included in the study underwent infertility treatment using the in vitro fertilization (IVF) + intracytoplasmic sperm injection (ICSI) protocol with controlled ovarian stimulation and transfer of native embryos into the uterine cavity (300 women – 58.8 %) or a cryoprotocol (210 patients – 41.2 %). The complex of conducted studies included clinical, laboratory, and instrumental methods.
Results. A statistically significant prevalence of submucous fibroid nodes was noted in the group with a failed current IVF attempt compared to the group with pregnancy resulting from IVF (13,4 % and 8,8 % respectively; p < 0,05), as well as the presence of a dominant node deforming the uterine cavity (37,1 % and 27,9 % respectively; p < 0.05) or located close to it (26,1 % and 19,3 % respectively; p < 0,05). Analysis of the nature of surgical interventions performed (surgical approach, frequency of myomectomies with opening of the uterine cavity, presence of fibroid conglomerates and adhesive process) revealed no significant differences in the study groups. At the same time, we noted a statistically significant prevalence of the share of surgical interventions involving the removal of fibroid nodes with signs of impaired blood supply in the group of patients with a failed subsequent IVF attempt compared to the group with pregnancy achievement (44,0 % and 26,3 % respectively; p < 0,05).
Conclusions. The risk factors for repeated failed ART programs in the group of patients with uterine fibroids with two or more ineffective ART attempts in history were found to be: woman’s age over 40 years during the ART program (OR 2.396, 95 % CI 1,120 5,124); duration of infertility over 5 years (OR 2.085, 95 % CI 1,044–4,164) and presence of 3 or more ineffective IVF attempts in history (OR 2.269, 95 % CI 1,011–5,094); presence of previously performed surgical interventions, such as uterine artery embolization (OR 2.979, 95 % CI 1,045–8,490) and ablation (OR 4.380, 95 % CI 1.129–16.985); submucous fibroid (OR 2.917, 95 % CI 1,825–4,661), presence of a dominant node located close to the uterine cavity (OR 1.822, 95 % CI 1,207–2,750), and presence of fibroid nodes with signs of impaired blood supply (OR 2.206, 95 % CI 1,069–4,552); combination of external genital endometriosis (OR 2.129, 95 % CI 1,061–4,274) and endometritis with uterine fibroids (OR 2.341 95 % CI 1,022–5,364).