Abstract

The relationship between uterine myomas and infertility is unclear, and numerous studies have attempted to better define this association. This review article explores the available data about the impact of submucosal, intramural and subserosal myomas, and small and large myomas, on reproductive outcomes in natural conception and assisted reproduction. Overall myoma location, followed by size, is the most important factor determining the impact of myomas on fertility. Distortion of the uterine cavity can also be detrimental to fertility. The importance of proper evaluation of a myomatous uterus and its endometrial cavity is discussed. For patients with myomas and infertility, or for those with symptomatic myomas who desire future fertility, current medical and surgical management options are reviewed. However, myomectomy remains the standard of care for patients with problematic myomas and fertility concerns.

Keywords: Myomectomy, endometrial cavities, hysterosalpingogram, intracytoplasmic sperm injection, implantation, conservative management, Mifepristone