Uterine fibroids and infertility: a controverse but concrete link

Abstract

Uterine fibroids and infertility: a controverse but concrete link Radmila Sparić1,2,*, Mladen Andjić1 , Lazar Nejković2,3 , Jelena Štulić3 , Aleksandar Dmitrović1,2 , Radomir Aničić2,3 , Zagorka Milovanović2,3 , Đina Tomašević4 , Andrea Tinelli5,6,7 1Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11103 Belgrade, Serbia 2School of Medicine, University of Belgrade, 11103 Belgrade, Serbia 3Clinic of Gynecology and Obstetrics, Narodni Front, 11103 Belgrade, Serbia 4University Clinical Centre of Serbia, 11103 Belgrade, Serbia 5Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), ”Veris delli Ponti Hospital”, 73100 Lecce, Italy 6Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, 73100 Lecce, Italy 7Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), 141700 Dolgoprudny, Russia *Correspondence: radmila@rcub.bg.ac.rs (Radmila Sparić) Academic Editor: Michael H. Dahan Submitted: 28 July 2021 Revised: 20 October 2021 Accepted: 3 November 2021 Published: 13 January 2022 Abstract Background: Uterine fibroids (UFs) are the most common female benign tumors linked to significant morbidity. There are large literature data connecting UFs with infertility and adverse pregnancy outcome. In this research, authors reviewed literature on UFs, analyzing their relationship with infertility, influence of different therapeutic approaches of UFs on fertility and the possible mechanisms related to UFs and infertility. Methods: MEDLINE and PubMed search, during the years 1990–2020 was performed using a combination of keywords on such topic. Peer-reviewed, systematic review, meta-analysis and prospective trials, examining relationship between UFs and infertility were included in this investigation. According to authors evaluation, additional articles were also identified from the retrieved papers references and included in this narrative review. Results: UFs, especially the submucous and intramural types, with related treatments are linked to impairment of fertility and adverse pregnancy outcome, but many data are conflicting. Molecular mechanisms investigations could explain relationship between UFs and infertility. Conclusion: UFs are linked to infertility and interventions improve fertility. However, many studies conflict in the final results, so further investigations on UFs and infertility should clarify the exact role of molecular mechanisms of this association. Keywords: Uterine fibroids; Leiomyomas; Fertility; Pregnancy; Myomectomy; In vitro fertilization; Pregnancy rate