Abstract
Traditionally, many physicians have advised their patients to delay starting IVF for at least two menstrual cycles after an extensive SMR, in order to allow for thorough healing of the endometrium prior to embryo transfer. The purpose of this study was to determine whether the time interval between SMR and subsequent IVF cycle significantly affects pregnancy outcomes. Retrospective cohort study. IVF cycle characteristics and pregnancy outcomes were compared between women who had undergone a single SMR less than 90 days prior to starting an IVF cycle, and women who waited between 91 and 365 days before starting IVF. Volumes of fibroid pathology specimens for each SMR were recorded. Mann-Whitney and Fisher's exact tests were used for statistical analysis. The mean number of days between having surgery and starting IVF was 52.6 days in the shorter time interval group, and 188.3 days in the longer time interval group. No significant differences in demographics, volume of removed fibroid, endometrial stripe on the day of HCG, implantation rate (IR), total pregnancy rate (TPR), live birth rate (LBR) or miscarriage rate (MR) were seen between women who had an IVF cycle within 90 days of their SMR and those who waited between 91 and 365 days.Tabled 1IVF Outcome byTime Interval After SMR≤90 days (52.6±22.0)91-365 days (188.3±75.3)P valueN=4066Age (yrs)39.9±2.539.1±3.10.14Fibroid volume (cm3)6.3±11.24.8±9.00.82Protocol (% Luteal suppression)73820.33# Prior IVF Cycles1.4±2.51.1±1.50.94Endometrial stripe on day of HCG9.77±2.099.67±2.090.76# Mature Oocytes9.8±8.28.3±4.10.63# embryos transferred3.72±1.202.95±1.470.20IR0.12±0.20.16±0.30.31TPR (%)37.545.40.54LBR (%)22.531.80.38MR (%)15.014.00.99 Open table in a new tab IVF soon after SMR does not appear to negatively affect outcome. Consequently, women do not have to delay IVF after surgery, and can safely start IVF within 2-3 menstrual cycles after SMR, without any negative impact on pregnancy rates.
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