The management of intramural fibroids in women with infertility

Abstract

Currently, there is insufficient evidence to make conclusions regarding the effect of intramural fibroids on fertility outcomes on natural and assisted conception. Practically, the most important task is to exclude any involvement of the uterine cavity by hysteroscopy or sonohysterography and not rely only on 2D transvaginal ultrasound. Furthermore, there is insufficient evidence from randomised controlled trials to evaluate the role of myomectomy for intramural fibroids to improve fertility. More high quality studies are necessary to address the effect of intramural fibroids on reproductive outcomes and the effect of removal of those fibroids on reproductive outcomes. Of note is that the surgical approach to myomectomy (open or laparoscopic) has no significant effect on fertility outcomes. In the meantime thorough counselling and individualised planning is recommended in women presenting with intramural fibroids and infertility.