| Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. | |
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MedLine Citation:
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PMID: 20719814 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The relationship between fibroids and infertility remains an unsolved question, and management of intramural fibroids is controversial. During the implantation phase, uterine peristalsis is dramatically reduced, which is thought to facilitate embryo implantation. Our aims were to evaluate (i) the occurrence and frequency of uterine peristalsis in infertile women with intramural fibroids and (ii) whether the presence of uterine peristalsis decreases the pregnancy rate. METHODS: Ninety-five infertile patients with uterine fibroids were examined using magnetic resonance imaging (MRI). Inclusion criteria were as follows: (i) presence of intramural fibroids, excluding submucosal type; (ii) no other significant infertility factors (excluding endometriosis); and (iii) regular menstrual cycles, and MRI performed at the time of implantation (luteal phase day 5-9). The frequency of junctional zone movement was evaluated using cine-mode-display MRI. After MRI, patients underwent infertility treatment for up to 4 months, and the pregnancy rate was evaluated prospectively. RESULTS: Fifty-one patients fulfilled the inclusion criteria, and 29 (57%) and 22 (43%) patients were assigned to the low (0 or 1 time/3 min) or high frequency (≥ 2 times/3 min) uterine peristalsis group, respectively. Endometriosis incidence was the same in both groups. Ten out of the 29 patients (34%) in the low-frequency group achieved pregnancy, compared with none of the 22 patients (0%) in the high-frequency group (P< 0.005). Comparing pregnant and non-pregnant cases, 4 of 10 patients (40%) and 9 of 41 patients (22%), respectively, had endometriosis (not significant). CONCLUSIONS: A higher frequency of uterine peristalsis during the mid-luteal phase might be one of the causes of infertility associated with intramural-type fibroids. |
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Authors:
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O Yoshino; T Hayashi; Y Osuga; M Orisaka; H Asada; S Okuda; M Hori; M Furuya; H Onuki; Y Sadoshima; H Hiroi; T Fujiwara; F Kotsuji; Y Yoshimura; O Nishii; Y Taketani |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-18 |
Journal Detail:
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Title: Human reproduction (Oxford, England) Volume: 25 ISSN: 1460-2350 ISO Abbreviation: Hum. Reprod. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-16 Completed Date: 2011-01-10 Revised Date: 2011-07-06 |
Medline Journal Info:
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Nlm Unique ID: 8701199 Medline TA: Hum Reprod Country: England |
Other Details:
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Languages: eng Pagination: 2475-9 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan. oyoshino624@hotmail.co.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Clomiphene / therapeutic use Endometriosis / diagnosis Female Fertility Agents, Female / therapeutic use Humans Infertility, Female / drug therapy, etiology* Leiomyoma / complications, physiopathology* Magnetic Resonance Imaging Menotropins / therapeutic use Ovulation Induction Peristalsis* Pregnancy Pregnancy Complications, Neoplastic / physiopathology* Pregnancy Rate* Prospective Studies Retrospective Studies Uterine Neoplasms / complications, physiopathology* |
| Chemical | |
Reg. No./Substance:
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0/Fertility Agents, Female; 61489-71-2/Menotropins; 911-45-5/Clomiphene |
| Comments/Corrections | |
Comment In:
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Hum Reprod. 2011 Jun;26(6):1597; author reply 1597
[PMID:
21459895
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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