Conservative therapy of uterine fibroids prior to in vitro fertilization treatment for infertility
Uterine fibroids are one of the most common diseases in reproductive-aged women, a risk factor for infertility, and reproductive failures. Patients with uterine fibroids are now managed by different strategies, including conservative treatment with high-efficacy gonadotropin-releasing hormone (GnRH) agonists.Devyatova E.A., Tsaturova K.A., Vartanyan E.V., Petukhova N.L., Markin A.V.
Objective. To evaluate the efficiency of conservative therapy with GnRH agonist (buserelin long) for uterine fibroids. To assess the results of IVF treatment for infertility and the course and outcome of pregnancy after using GnRH agonists for the therapy of uterine fibroids. To substantiate pathogenetic GnRH agonist therapy as part of pregravid preparation in patients with infertility and uterine fibroids.
Subjects and methods. A retrospective comparative study of pregnancy outcomes was performed in 69 women with uterine fibroids and infertility. The inclusion criteria were age younger than 45 years, an anti-Müllerian hormone concentration of>1.0 pg/ml, the absence of severe extragenital pathology, the presence of types 2–6 fibroids, and good-quality embryos.
Conclusion. The use of GnRH agonists (buserelin long) as part of comprehensive pregravid preparation is a highly effective conservative treatment for uterine fibroids. After GnRH agonist therapy, there was a significant increase in IVF pregnancy rates as compared to population-based rates The low rate of gestational complications in pregnant women who had received GnRH agonist therapy for uterine fibroids before entry into the IVF program indicates the validity of this management tactics for infertility concurrent with uterine fibroids.
Keywords
uterine fibroids
GnRH agonists
pregnancy
IVF
infertility
miscarriage
Supplementary Materials
- Table 1. Gynecological disorders and obstetric anamnesis in groups
- Table 2. Complications of pregnancy in groups
References
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Received 16.12.2016
Accepted 23.12.2016
About the Authors
Devyatova Ekaterina Aleksandrovna, MD, doctor of ultrasound diagnostics, obstetrician-gynecologist, «Test-Tube Baby» Clinic for Assisted Reproductive Technology.123182, Russia, Moscow, Shchukinskaya str. 2. Tel.: +79036645417. E-mail: katepillar@mail.ru
Tsaturova Kristina Ashotovna, MD, chief physician, obstetrician-gynecologist, reproductive specialist, «Test-Tube Baby» Clinic for Assisted Reproductive Technology.
123182, Russia, Moscow, Shchukinskaya str. 2. Tel.: +74959818580
Vartanyan Emma Vramovna, MD, professor of the Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples’ Friendship University of Russia,
President of the self-regulating society «Association of VRT Clinics», obstetrician-gynecologist, reproductologist, director of «Test-Tube Baby» Clinic for Assisted Reproductive Technology. 123182, Russia, Moscow, Shchukinskaya str. 2. Tel.: +74959818580
Petuhova N.L., Obstetrician-gynecologist, reproductive specialist, «Test-Tube Baby» Clinic for Assisted Reproductive Technology.
123182, Russia, Moscow, Shchukinskaya str. 2. Tel.: +74959818580
Markin A.V., embryologist, «Test-Tube Baby» Clinic for Assisted Reproductive Technology. 123182, Russia, Moscow, Shchukinskaya str. 2. Tel.: +74959818580
For citations: Devyatova E.A., Tsaturova K.A., Vartanyan E.V., Petukhova N.L., Markin A.V. Conservative therapy of uterine fibroids prior to in vitro fertilization treatment for infertility. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 131-8. (in Russian)
http://dx.doi.org/10.18565/aig.2017.3.131-8
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