Fertility and Sterility
Volume 90, Issue 5 , Pages 2004.e19-2004.e21, November 2008

Ovarian response in women undergoing ovarian stimulation after myomectomy

  • Hyacinth Browne, M.D.

      Affiliations

    • Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    • Reproductive Endocrinology and Infertility, Walter Reed Army Medical Center, Washington, D.C
    • Corresponding Author InformationReprint requests: Hyacinth Browne, M.D., Program in Reproductive and Adult Endocrinology, NICHD, CRC 1 East Rm 1-E-3140, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892 (FAX: 301-402-0884).
    • ,
  • Desiree McCarthy-Keith, M.D., M.P.H.

      Affiliations

    • Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    • Reproductive Endocrinology and Infertility, Walter Reed Army Medical Center, Washington, D.C
    • ,
  • Barbara Stegmann, M.D., M.P.H.

      Affiliations

    • Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    • Reproductive Endocrinology and Infertility, Walter Reed Army Medical Center, Washington, D.C
    • ,
  • James Spies, M.D.

      Affiliations

    • Interventional Radiology Section, Department of Radiology, Georgetown University Hospital, Washington, D.C
    • ,
  • Alicia Armstrong, M.D., M.H.S.C.R.

      Affiliations

    • Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
    • Reproductive Endocrinology and Infertility, Walter Reed Army Medical Center, Washington, D.C

Received 4 January 2008; received in revised form 3 April 2008; accepted 3 April 2008. published online 19 June 2008.

Objective

To examine ovarian response in infertile women undergoing ovarian stimulation after abdominal myomectomy.

Design

Case report.

Setting

Academic medical research center.

Patient(s)

Four infertile women with known fibroids who had a failed assisted reproductive technology (ART) cycle followed by an abdominal myomectomy.

Intervention(s)

Infertile women with known fibroids who had a failed ART cycle, from January 2000 to December 2006, followed by an abdominal myomectomy and a subsequent ART cycle.

Main Outcome Measure(s)

Ovarian function before (baseline) and after myomectomy was assessed by age, day 3 and day 10 FSH levels, days of stimulation, total gonadotropins used, peak E2 level, the number of oocytes retrieved and embryos obtained, the number of high-grade embryos, and pregnancy outcome.

Result(s)

The mean age was 35 and 36 years before and after myomectomy, respectively. All subjects had uterine factor infertility. Two of these women also had tubal factor infertility, and one had endometriosis and male factor infertility. There was no difference in ovarian response before and after myomectomy.

Conclusion(s)

As expected, abdominal myomectomy did not adversely affect ovarian response in infertile women undergoing ovarian stimulation after a failed ART cycle. Larger randomized prospective studies are needed to accurately assess whether myomectomy has a negative impact on ovarian response.

Key Words: Fibroids, myomectomy, ovarian reserve, assisted reproductive technology

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 H.B. has nothing to disclose. D.M.-K. has nothing to disclose. B.S. has nothing to disclose. J.S. has nothing to disclose. A.A. has nothing to disclose.

 Carried out under Walter Reed Army Medical Center Department of Clinical Investigations protocol WU #08-04-44018hEX(1) and supported in part by the Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health.

PII: S0015-0282(08)00799-1

doi:10.1016/j.fertnstert.2008.04.008

Fertility and Sterility
Volume 90, Issue 5 , Pages 2004.e19-2004.e21, November 2008

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