An observational study of treatment outcomes of Uterine Myoma among clients who had undergone invitro fertilization at a Public Center in Addis Ababa, Ethiopia

Abstract

Background: For clients undergoing invitro-fertilization (IVF), there is no consensus regarding the management of non-cavity-distorting intramural myoma.

Background: To assess the prevalence and treatment outcomes of IVF clients with uterine myoma.

Methods: A 2-year (April 1, 2019–April 1, 2021) chart review was conducted for 1300 infertile women who had undergone IVF. Categorical data were summarized in proportion, and continuous data were summarized using the mean, median, and standard deviation where appropriate. Bivariate logistic regression was conducted to assess the association between predictor variables and the outcome variable (clinical pregnancy). P-values of 0.05 were considered significant.

Results: Of the total 1,300 IVF clients, 282 (21.7%) cases were diagnosed as having myoma. Among the 13 cases of cavity-distorting intramural myomas who underwent IVF without myomectomy, all were negative for clinical pregnancy, whereas among the 60 cases of cavity-distorting myomas who had pre-IVF myomectomy followed by IVF, 16 (26.7%) were positive for clinical pregnancy. This difference was not statistically significant (P = 0.160). 38 (27.5%) of 138 cases of non-cavity-distorting intramural myoma who underwent IVF without pre-IVF myomectomy had clinical pregnancy. In contrast, among the 19 cases who had undergone pre-IVF myomectomy followed by IVF, only 2 (10.5%) had a clinical pregnancy. This difference was not statistically significant (P = 0.160).

Conclusion: While not statistically significant, conducting a pre-IVF myomectomy for cavity-distorting myomas improves the clinical pregnancy, whereas a pre-IVF myomectomy does not improve the clinical pregnancy for women with non-cavity-distorting myomas. We recommend further research with a larger sample size.