Myomectomy Decreases Abnormal Uterine Peristalsis and Increases Pregnancy Rate

被引:64
作者
Yoshino, Osamu [1 ,6 ]
Nishii, Osamu [6 ]
Osuga, Yutaka
Asada, Hisanori [2 ]
Okuda, Shigeo [3 ]
Orisaka, Makoto [8 ]
Hori, Masaaki [4 ]
Fujiwara, Toshihiro [5 ]
Hayashi, Toshihiko [7 ]
机构
[1] Univ Tokyo, Dept Obstet & Gynecol, Bunkyo Ku, Tokyo 1138655, Japan
[2] Keio Univ, Dept Obstet & Gynecol, Tokyo, Japan
[3] Keio Univ, Dept Radiol, Tokyo, Japan
[4] Juntendo Univ, Dept Radiol, Tokyo, Japan
[5] Sanno Hosp, Reprod Ctr, Tokyo, Japan
[6] Teikyo Univ, Dept Obstet & Gynecol, Mizonokuchi Hosp, Kanagawa, Japan
[7] Teikyo Univ, Dept Radiol, Mizonokuchi Hosp, Kanagawa, Japan
[8] Univ Fukui, Dept Obstet & Gynecol, Fukui 910, Japan
关键词
Uterine fibroma; Cine MRI; Uterine peristalsis; Infertility; Myomectomy;
D O I
10.1016/j.jmig.2011.09.010
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: The relationship between fibroids and infertility remains a critical and unresolved question. During the implantation phase, it is known that uterine peristalsis is dramatically reduced, which is thought to facilitate implantation of the embryo to the endometrium. In the previous study, using a cine MRI mode, we found that less than half of the patients with intramural fibroids exhibited abnormal uterine peristalsis during the mid-luteal phase. In the present study, we further investigated whether myomectomy for patients in the high peristalsis group is a constructive method to normalize uterine peristalsis. Methods: The frequency of junctional zone movement was evaluated using a cine MRI mode during the mid-luteal phase. Fifteen infertility patients, who had intramural myomas and exhibited abnormal uterine peristalsis (>= 2 times/3 min) in their first MRI, underwent myomectomy and a second MRI. After receiving the second MRI, patients underwent infertility treatment for at least 8 months, and pregnancy rate was evaluated prospectively. Results: Among 15 patients, the frequency of uterine peristalsis was normalized (0 or 1 time/3min) in 14 patients. Following myomectomy and second MRI test, 6 of the 15 patients achieved pregnancy (n = 15, pregnancy rate: 40%). Conclusions: The presence of uterine fibroids might induce abnormal uterine peristalsis in some patients, leading to infertility, and myomectomy may improve fertility in these patients. Journal of Minimally Invasive Gynecology (2012) 19, 63-67 (C) 2012 AAGL. All rights reserved.
引用
收藏
页码:63 / 67
页数:5
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