Effect of the Distance of Interstitial Fibroid of Less Than 4 cm from the Outer Surface of the Endometrium on Outcome of Intra Cytoplasmic Sperm Injection

Shehab, Shehab Ahmed Mahmoud; El-Ghandour, Abdel-Aal Mohamed; Fakher, Osama Abd El Aziz Mohamed; Amer, Ahmed Samy

doi:/10.21608/aimj.2025.446472

Effect of the Distance of Interstitial Fibroid of Less Than 4 cm from the Outer Surface of the Endometrium on Outcome of Intra Cytoplasmic Sperm Injection

Document Type : Original Article

Authors

¹ Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Obstetrics and Gynecology, International Islamic Center for Population Study and Research, Cairo, Egypt

³ Public Health, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

/10.21608/aimj.2025.446472

Abstract

Background: Uterine fibroids, the most prevalent benign tumors of the female reproductive system, affect about 25% of women undergoing in vitro fertilization-embryo transfer (IVF-ET). In the general population, they are 20–50% prevalent and usually afflict women between the ages of 30 and 50. It is well recognized that uterine distorting intramural or submucous fibroids reduce the efficiency of reproductive therapies; yet, their removal appears to boost fertility.
Aim of the Work: To assess the effect of the distance of interstitial fibroid from the outer surface of the endometrium on outcomes of Intra Cytoplasmic Sperm Injection cycles.
Patients and Methods: This prospective clinical trial was conducted on 300 infertile women underwent ICSI and were recruited from the ART-unit of the International Islamic Center for Population trial and Research from September 2021 to September 2023.
Results: Our study results revealed that Live birth rate was significantly highest in control group (44%), followed by fibroid >3 mm group (27%) and lowest in fibroid 1-3 mm group (23%), with no statistically significant difference between the two fibroid groups (p value= 0.003).
Conclusion: Non-cavity-distorting intramural fibroids have a detrimental effect on the clinical pregnancy, rates of implantation and live birth in patients undergoing IVF-ICSI, based on the smallest distance among intramural uterine fibroids and the endometrium in type 3 fibroids. However, they do not significantly raise the clinical miscarriage risk in either of the two kinds of uterine fibroids (1–3 mm and >3 mm).

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