When Should Uterine Fibroids Be Treated?

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• Pritts EA, Parker WH, Olive DL. Fibroids and infertility; an updated systematic review of the evidence. Fertil Steril 2009;91:1215–23. This is our most recent meta-analysis that addresses the controversial issue of the role that fibroids play upon infertility.

•• Bozdag G, Esinler I, Boynukalin K, et al. Single intramural leiomyoma with normal hysteroscopic findings does not affect ICSI-embryo transfer outcome. Reprod Biomed Online 2009;19:276–80. This is the best study thus far addressing intramural fibroids, showing that indeed if there is no intracavitary component, in a homogenous population, pregnancy rates are not affected.

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•• Kinugasa-Taniguchi Y, Ueda Y, Hara-Ohyagi C, et al. Impaired delivery outcomes in pregnancies following myomectomy compared to myoma-complicated pregnancies. J Reprod Med 2011;56:142–8. Although a retrospective study, this was the first to challenge expert opinion that large intramural fibroids should be removed to confer safer delivery; in fact it argues against this practice based upon the outcomes.

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Mara M, Maskova J, Fucikova Z, et al. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol. 2008;31:73–85.