Document Detail


Submucous myomas and their implications in the pregnancy rates of patients with otherwise unexplained primary infertility undergoing hysteroscopic myomectomy: a randomized matched control study.
MedLine Citation:
PMID:  19406399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether hysteroscopic myomectomy for submucous fibroids in women with unexplained primary infertility achieved better pregnancy rates than no intervention.
DESIGN: Prospective randomized matched control trial.
SETTING: Tertiary university fertility care unit.
PATIENT(S): From January 1999 to February 2006, a total of 215 women with unexplained primary infertility and with ultrasonographically diagnosed submucous myomas as the sole cause for fertility failure were recruited.
INTERVENTION(S): Women were randomly allocated to one of two pretreatment groups matched by age. Hysteroscopic myomectomy was performed in the study group (n = 101). Diagnostic hysteroscopy and myoma biopsy was performed in the control group (n = 103). No fertility therapy was given for either group.
MAIN OUTCOME MEASURE(S): Clinical pregnancy rates according to patient and myoma characteristics.
RESULT(S): The baseline characteristics of both patients and submucous myomas were comparable. Among patients with complete follow-up, a total of 93 (45.6%) pregnancies occured-64 (63.4%) in the study group and 29 (28.2%) in the control group. Women in the study group had a better possibility of becoming pregnant after hysteroscopic myomectomy with a relative risk of 2.1 (95% confidence interval, 1.5-2.9). No difference in pregnancy rates was observed according to size, number, and location of myomas in both groups. However, fertility rates appeared to increase after hysteroscopic myomectomy of type 0 and type I myomas (P < 0.05). In contrast, for the subgroup of patients with type II myomas, no difference in fertility rates were noted.
CONCLUSION(S): Hysteroscopic myomectomy for submucous fibroids in women with unexplained primary infertility is effective in achieving a better pregnancy rate. We think that a multicenter study should be conducted before evaluating the impact of submucous myoma characteristics on fertility outcome.
Authors:
Tarek Shokeir; Muhammed El-Shafei; Hamed Yousef; Abdel-Fattah Allam; Ehab Sadek
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Retracted Publication     Date:  2009-05-05
Journal Detail:
Title:  Fertility and sterility     Volume:  94     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-07-23     Revised Date:  2011-10-11    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  724-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. tarekshokeir@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Follow-Up Studies
Humans
Hysteroscopy / methods*
Infertility, Female / surgery*,  ultrasonography
Leiomyoma / surgery*,  ultrasonography
Pregnancy
Pregnancy Rate*
Prospective Studies
Treatment Outcome
Uterine Neoplasms / surgery*,  ultrasonography
Young Adult
Comments/Corrections
Retraction In:
Fertil Steril. 2011 Sep;96(3):800   [PMID:  21880283 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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