The Effect of Non-Cavity-Distorting Myomas on the Outcomes of Stimulated Intrauterine Insemination in Unexplained Infertility

Objective: To investigate the relationship between reproductive outcomes and noncavity-distorting uterine myomas in women with unexplained infertility and undergoing ovulation induction and intrauterine insemination (OI-IUI). Material and Methods: Women between 18-40 years of age with regular ovulatory cycles and bilateral tubal patency as detected on hysterosalpingography (HSG) and with spouses having total progressive motile sperm (TPMSS) counts >5 million on spermiogram analysis, were included in this study. The number of women with noncavity-distorting myomas, as detected using ultrasonography, were recorded. The frequencies of pregnancies after OI-IUI, ectopic pregnancies, abortions, clinical pregnancies, and live births were compared between women with non-cavity-distorting myomas and those without myomas. Results: A total of 857 cycles of OI-IUI were administered to 436 patients, resulting in 110 pregnancies. Non-cavity-distorting myomas were recorded in 27 subjects. Using multivariate logistic regression analysis, the presence of non-cavity-distorting myoma significantly affected pregnancy (p<0.05). Conception (p=0.008), clinical pregnancy (p=0.034), and live birth rates (p=0.037) were significantly higher in patients without fibroids than those with fibroids. Conclusion: Conception, clinical pregnancy, and live birth rates were significantly higher in patients without uterine fibroids than those with fibroids. These findings suggest that myomas might have negative effects on fertility outcomes.