Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

National Institute of Child Health and Human Development Reproductive Medicine Network

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective To investigate the association of non–cavity-distorting uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination (OS-IUI) in couples with unexplained infertility. Design Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes after OS-IUI. Setting Reproductive Medicine Network clinical sites. Patient(s) Nine hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. Intervention(s) Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins), and treatment was continued for up to four cycles or until pregnancy was achieved. Main Outcomes Measure(s) Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. Result(s) A total of 102/900 participants (11.3%) had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum antimüllerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than in those without uterine fibroids. Pregnancy loss before 12 weeks was more likely in African American women with fibroids compared with non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids. Conclusion(s) No differences were observed in conception and live birth rates in women with non–cavity-distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non–cavity-distorting fibroids undergoing OS-IUI for unexplained infertility. Clinical Trial Registration Number NCT01044862.

Original languageEnglish (US)
Pages (from-to)756-762.e3
JournalFertility and sterility
Volume107
Issue number3
DOIs
StatePublished - Mar 1 2017

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Insemination
Leiomyoma
Pregnancy Outcome
Infertility
Birth Rate
Live Birth
Pregnancy
letrozole
African Americans
Clinical Trials
Reproductive Medicine
Fetal Movement
Clomiphene
Ovulation Induction
Pregnancy Rate
Serum
Gonadotropins
Multicenter Studies
Fertility
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

National Institute of Child Health and Human Development Reproductive Medicine Network. / Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility. In: Fertility and sterility. 2017 ; Vol. 107, No. 3. pp. 756-762.e3.
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title = "Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility",
abstract = "Objective To investigate the association of non–cavity-distorting uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination (OS-IUI) in couples with unexplained infertility. Design Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes after OS-IUI. Setting Reproductive Medicine Network clinical sites. Patient(s) Nine hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. Intervention(s) Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins), and treatment was continued for up to four cycles or until pregnancy was achieved. Main Outcomes Measure(s) Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. Result(s) A total of 102/900 participants (11.3{\%}) had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum antim{\"u}llerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than in those without uterine fibroids. Pregnancy loss before 12 weeks was more likely in African American women with fibroids compared with non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids. Conclusion(s) No differences were observed in conception and live birth rates in women with non–cavity-distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non–cavity-distorting fibroids undergoing OS-IUI for unexplained infertility. Clinical Trial Registration Number NCT01044862.",
author = "{National Institute of Child Health and Human Development Reproductive Medicine Network} and Styer, {Aaron K.} and Susan Jin and Dan Liu and Baisong Wang and Polotsky, {Alex J.} and Christianson, {Mindy S.} and Wendy Vitek and Lawrence Engmann and Karl Hansen and Robert Wild and Legro, {Richard S.} and Christos Coutifaris and Ruben Alvero and Robinson, {Randal D.} and Peter Casson and Christman, {Gregory M.} and Alicia Christy and Diamond, {Michael P.} and Esther Eisenberg and Heping Zhang and Nanette Santoro",
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Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility. / National Institute of Child Health and Human Development Reproductive Medicine Network.

In: Fertility and sterility, Vol. 107, No. 3, 01.03.2017, p. 756-762.e3.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

AU - National Institute of Child Health and Human Development Reproductive Medicine Network

AU - Styer, Aaron K.

AU - Jin, Susan

AU - Liu, Dan

AU - Wang, Baisong

AU - Polotsky, Alex J.

AU - Christianson, Mindy S.

AU - Vitek, Wendy

AU - Engmann, Lawrence

AU - Hansen, Karl

AU - Wild, Robert

AU - Legro, Richard S.

AU - Coutifaris, Christos

AU - Alvero, Ruben

AU - Robinson, Randal D.

AU - Casson, Peter

AU - Christman, Gregory M.

AU - Christy, Alicia

AU - Diamond, Michael P.

AU - Eisenberg, Esther

AU - Zhang, Heping

AU - Santoro, Nanette

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective To investigate the association of non–cavity-distorting uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination (OS-IUI) in couples with unexplained infertility. Design Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes after OS-IUI. Setting Reproductive Medicine Network clinical sites. Patient(s) Nine hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. Intervention(s) Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins), and treatment was continued for up to four cycles or until pregnancy was achieved. Main Outcomes Measure(s) Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. Result(s) A total of 102/900 participants (11.3%) had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum antimüllerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than in those without uterine fibroids. Pregnancy loss before 12 weeks was more likely in African American women with fibroids compared with non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids. Conclusion(s) No differences were observed in conception and live birth rates in women with non–cavity-distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non–cavity-distorting fibroids undergoing OS-IUI for unexplained infertility. Clinical Trial Registration Number NCT01044862.

AB - Objective To investigate the association of non–cavity-distorting uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination (OS-IUI) in couples with unexplained infertility. Design Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes after OS-IUI. Setting Reproductive Medicine Network clinical sites. Patient(s) Nine hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. Intervention(s) Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins), and treatment was continued for up to four cycles or until pregnancy was achieved. Main Outcomes Measure(s) Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. Result(s) A total of 102/900 participants (11.3%) had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum antimüllerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than in those without uterine fibroids. Pregnancy loss before 12 weeks was more likely in African American women with fibroids compared with non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids. Conclusion(s) No differences were observed in conception and live birth rates in women with non–cavity-distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non–cavity-distorting fibroids undergoing OS-IUI for unexplained infertility. Clinical Trial Registration Number NCT01044862.

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