Improved Fertility Following Enucleation of Intramural Myomas in Infertile Women

作     者：Yu-Cui Tian Jian-Hong Wu Hong-Mei Wang Yin-Mei Dai 

作者机构：Department of Perinatal Medicine Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China Department of Gynecology Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China Department of Minimal Invasive Gynecology Center Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2017年第130卷第14期

页      面：1648-1653页

核心收录：

学科分类：090603[农学-临床兽医学] 02[经济学] 0202[经济学-应用经济学] 020208[经济学-统计学] 07[理学] 09[农学] 0906[农学-兽医学] 0714[理学-统计学（可授理学、经济学学位）] 070103[理学-概率论与数理统计] 0701[理学-数学] 

基　　金：supported by grants from Beijing Municipal Science and Technology Commission Beijing Obstetrics and Gynecology Hospital, Capital Medical University 

主　　题：Infertility Myoma Pregnancy Outcome Uterine Myomectomy 

摘      要：Background：The relationship between intramural myomas and fertility remains *** main debate rests on whether cavity-distorting intramural lnyomas （CDMs） adversely affect fertility more than *** aimed to compare the effects ofenucleating non-CDMs and CDMs on fertility improvement in females with unexplained ***：We prospectively recruited 83 women undergoing myomectomy for unexplained infertility with intramural myomas between June 2008 and November 2012 and classified them into non-CDMs group （n =45） and CDMs group （n =38）.We then compared postoperative infertility rates,spontaneous pregnancy rates,pregnancy outcomes,live birth rates,and obstetric *** continuous variables,we calculated the mean ± standard deviation,median and interquartile range,and analyzed the data using Student＇s t-test and the Mann-Whitney *** categorical variables,the Pearson＇s Chi-square test,the continuity correction test,and Fisher＇s exact test were ***：Patients＇ demographics and myoma characteristics were comparable between the two *** overall spontaneous pregnancy rate increased from 0% to 68.42% following *** postoperative infertility rate was significantly higher in the non-CDMs group than that in the CDMs group （50.00% vs.23.53%,t =5.579,P =0.018）,whereas the postoperative spontaneous pregnancy rate was significantly lower in the non-CDMs group than that in the CDMs group （47.62% vs.70.59%,t 4.067,P =0.044）.Compared with the enucleation ofnon-CDM,the enucleation of CDM patients was a protective factor for the fertility restoration （risk ratio [RR] =3.717,95% confidence interval [CI]：1.284-10.753,P =0.015）,although postoperative fertility restoration declined with age （RR =1.141,95% CI：1.005-1.295,P =0.041）.Conclusions：Intramural myomas are associated with impaired *** experiencing unexplained infertility,and possessing intramural myomas,have a better chance of conception following myomectomy,and t