Document Detail

Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids.
MedLine Citation:
PMID:  20719814     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-18
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  25     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-10     Revised Date:  2011-07-06    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2475-9     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Tokyo, Tokyo 113-8655, Japan.
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MeSH Terms
Clomiphene / therapeutic use
Endometriosis / diagnosis
Fertility Agents, Female / therapeutic use
Infertility, Female / drug therapy,  etiology*
Leiomyoma / complications,  physiopathology*
Magnetic Resonance Imaging
Menotropins / therapeutic use
Ovulation Induction
Pregnancy Complications, Neoplastic / physiopathology*
Pregnancy Rate*
Prospective Studies
Retrospective Studies
Uterine Neoplasms / complications,  physiopathology*
Reg. No./Substance:
0/Fertility Agents, Female; 61489-71-2/Menotropins; 911-45-5/Clomiphene
Comment In:
Hum Reprod. 2011 Jun;26(6):1597; author reply 1597   [PMID:  21459895 ]

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