Myomas (known as fibroids) are the commonest benign tumors of the uterus. Consequently, myomas are frequently observed in women undergoing IVF.
Recently, many studies have tried to examine if myomas have a negative impact on the IVF results and fertility. Regarding these myomas that distort the uterine cavity (where embryo implantation takes place) there is evidence that they negatively affect fertility and IVF results; these myomas should be removed before any IVF attempt by operative hysteroscopy. This procedure, when performed by an experienced surgeon, can give excellent results. Regarding those myomas that do not distort the uterine cavity (intramural and subserosal myomas) the evidence is conflicting: some studies report a potential adverse effect on IVF results (especially for large myomas), but the most powerful studies have failed to confirm such an effect. Additionally, there is not enough evidence to support any beneficial effect on IVF after the surgical removal of those myomas. Consequently, any decision should be individualized according to the specific circumstances of each patient.