Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids

O. Yoshino, T. Hayashi, Y. Osuga, M. Orisaka, H. Asada, Shigeo Okuda, M. Hori, M. Furuya, H. Onuki, Y. Sadoshima, H. Hiroi, T. Fujiwara, F. Kotsuji, Y. Yoshimura, O. Nishii, Y. Taketani

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The relationship between fibroids and infertility remains an unsolved question, and management of intramural fibroids is controversial. During the implantation phase, uterine peristalsis is dramatically reduced, which is thought to facilitate embryo implantation. Our aims were to evaluate (i) the occurrence and frequency of uterine peristalsis in infertile women with intramural fibroids and (ii) whether the presence of uterine peristalsis decreases the pregnancy rate. METHODS: Ninety-five infertile patients with uterine fibroids were examined using magnetic resonance imaging (MRI). Inclusion criteria were as follows: (i) presence of intramural fibroids, excluding submucosal type; (ii) no other significant infertility factors (excluding endometriosis); and (iii) regular menstrual cycles, and MRI performed at the time of implantation (luteal phase day 5-9). The frequency of junctional zone movement was evaluated using cine-mode-display MRI. After MRI, patients underwent infertility treatment for up to 4 months, and the pregnancy rate was evaluated prospectively. RESULTS: Fifty-one patients fulfilled the inclusion criteria, and 29 (57) and 22 (43) patients were assigned to the low (0 or 1 time/3 min) or high frequency (≥2 times/3 min) uterine peristalsis group, respectively. Endometriosis incidence was the same in both groups. Ten out of the 29 patients (34) in the low-frequency group achieved pregnancy, compared with none of the 22 patients (0) in the high-frequency group (P< 0.005). Comparing pregnant and non-pregnant cases, 4 of 10 patients (40) and 9 of 41 patients (22), respectively, had endometriosis (not significant). CONCLUSIONS: A higher frequency of uterine peristalsis during the mid-luteal phase might be one of the causes of infertility associated with intramural-type fibroids.

Original languageEnglish
Pages (from-to)2475-2479
Number of pages5
JournalHuman Reproduction
Volume25
Issue number10
DOIs
Publication statusPublished - 2010 Oct

Fingerprint

Peristalsis
Leiomyoma
Pregnancy Rate
Infertility
Endometriosis
Magnetic Resonance Imaging
Luteal Phase
Menstrual Cycle
Pregnancy
Incidence

Keywords

  • cine magnetic resonance imaging
  • infertility
  • intramural fibroids
  • uterine fibroma
  • uterine peristalsis

ASJC Scopus subject areas

  • Rehabilitation
  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Yoshino, O., Hayashi, T., Osuga, Y., Orisaka, M., Asada, H., Okuda, S., ... Taketani, Y. (2010). Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Human Reproduction, 25(10), 2475-2479. https://doi.org/10.1093/humrep/deq222

Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. / Yoshino, O.; Hayashi, T.; Osuga, Y.; Orisaka, M.; Asada, H.; Okuda, Shigeo; Hori, M.; Furuya, M.; Onuki, H.; Sadoshima, Y.; Hiroi, H.; Fujiwara, T.; Kotsuji, F.; Yoshimura, Y.; Nishii, O.; Taketani, Y.

In: Human Reproduction, Vol. 25, No. 10, 10.2010, p. 2475-2479.

Research output: Contribution to journalArticle

Yoshino, O, Hayashi, T, Osuga, Y, Orisaka, M, Asada, H, Okuda, S, Hori, M, Furuya, M, Onuki, H, Sadoshima, Y, Hiroi, H, Fujiwara, T, Kotsuji, F, Yoshimura, Y, Nishii, O & Taketani, Y 2010, 'Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids', Human Reproduction, vol. 25, no. 10, pp. 2475-2479. https://doi.org/10.1093/humrep/deq222
Yoshino, O. ; Hayashi, T. ; Osuga, Y. ; Orisaka, M. ; Asada, H. ; Okuda, Shigeo ; Hori, M. ; Furuya, M. ; Onuki, H. ; Sadoshima, Y. ; Hiroi, H. ; Fujiwara, T. ; Kotsuji, F. ; Yoshimura, Y. ; Nishii, O. ; Taketani, Y. / Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. In: Human Reproduction. 2010 ; Vol. 25, No. 10. pp. 2475-2479.
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AU - Hayashi, T.

AU - Osuga, Y.

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AU - Asada, H.

AU - Okuda, Shigeo

AU - Hori, M.

AU - Furuya, M.

AU - Onuki, H.

AU - Sadoshima, Y.

AU - Hiroi, H.

AU - Fujiwara, T.

AU - Kotsuji, F.

AU - Yoshimura, Y.

AU - Nishii, O.

AU - Taketani, Y.

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N2 - BACKGROUND: The relationship between fibroids and infertility remains an unsolved question, and management of intramural fibroids is controversial. During the implantation phase, uterine peristalsis is dramatically reduced, which is thought to facilitate embryo implantation. Our aims were to evaluate (i) the occurrence and frequency of uterine peristalsis in infertile women with intramural fibroids and (ii) whether the presence of uterine peristalsis decreases the pregnancy rate. METHODS: Ninety-five infertile patients with uterine fibroids were examined using magnetic resonance imaging (MRI). Inclusion criteria were as follows: (i) presence of intramural fibroids, excluding submucosal type; (ii) no other significant infertility factors (excluding endometriosis); and (iii) regular menstrual cycles, and MRI performed at the time of implantation (luteal phase day 5-9). The frequency of junctional zone movement was evaluated using cine-mode-display MRI. After MRI, patients underwent infertility treatment for up to 4 months, and the pregnancy rate was evaluated prospectively. RESULTS: Fifty-one patients fulfilled the inclusion criteria, and 29 (57) and 22 (43) patients were assigned to the low (0 or 1 time/3 min) or high frequency (≥2 times/3 min) uterine peristalsis group, respectively. Endometriosis incidence was the same in both groups. Ten out of the 29 patients (34) in the low-frequency group achieved pregnancy, compared with none of the 22 patients (0) in the high-frequency group (P< 0.005). Comparing pregnant and non-pregnant cases, 4 of 10 patients (40) and 9 of 41 patients (22), respectively, had endometriosis (not significant). CONCLUSIONS: A higher frequency of uterine peristalsis during the mid-luteal phase might be one of the causes of infertility associated with intramural-type fibroids.

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