Do benign growths around the uterus affect pregnancy outcomes in unexplained infertility?

This paper studied whether uterine fibroids can affect pregnancy outcomes following ovarian stimulation with intrauterine insemination. Authors reported no differences in live birth rates in women with fibroids and those without fibroids.

Uterine fibroids are non-cancerous growths around the uterus. Studies have been unclear as to whether fibroids affect pregnancy outcomes, particularly in couples with unexplained infertility. It has been suggested that there could be a link between unexplained infertility and fibroids. Ovarian stimulation refers to the use of medication to induce release of eggs by the ovaries. Intrauterine insemination is a type of ovarian stimulation. It refers to a process whereby the sperm is inserted into the uterus to help it fertilize the egg. 

900 couples with unexplained fertility were studied. The women underwent ovarian stimulation with intrauterine insemination. 102 women of the women had fibroids. Pregnancy outcomes were compared to 798 women without fibroids.

Women with fibroids were more likely to be older, have a greater uterus size, and be African American. No difference was observed in sperm count in couples with or without fibroids. There was also no difference in the response of the ovaries to stimulation. The pregnancy rate was 59.5% among women with fibroids. This was significantly higher among women without fibroids (80.1%). However, there were no significant differences in live birth, birth weight, and complications of delivery between women.

When factors such as age, health, and previous treatment were considered, there were no significant differences in pregnancy, loss of pregnancy, or live birth rate between women with or without fibroids.

Among women with fibroids, African American women were more likely to have a clinical pregnancy loss before the 12th week of gestation compared to non-African American women.  

The authors concluded that live birth rates were not significantly different in women with fibroids compared to those without following ovarian stimulation with intrauterine insemination.