Lower prevalence of non–cavity-distorting uterine fibroids in patients with polycystic ovary syndrome than in those with unexplained infertility

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Authors:

Hao Huang, M.D., MPH, Hongying Kuang, M.D., Ph.D., Fangbai Sun, M.P.H., Michael P. Diamond, M.D., Richard S. Legro, M.D., Christos Coutifaris, M.D., Ph.D., Ruben Alvero, M.D., Randal D. Robinson, M.D., Peter R. Casson, M.D., Gregory M. Christman, M.D., Karl R. Hansen, M.D., Ph.D., Nanette Santoro, M.D., Esther Eisenberg, M.D., M.P.H., Heping Zhang, Ph.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network

Abstract:

Objective

To study whether there is a difference in the prevalence of non–cavity-distorting uterine fibroids between infertile patients with polycystic ovary syndrome (PCOS) and those with unexplained infertility (UI).

Design

A secondary analysis of data from three randomized clinical trials.

Setting

Academic health centers.

Patient(s)

A total of 2,249 patients with normal uterine cavities.

Interventions(s)

None.

Main Outcome Measure(s)

The presence or absence of non–cavity-distorting fibroids.

Result(s)

Compared with women with UI, those with PCOS were younger, had a higher body mass index, and were more likely to be Hispanic or African American, with a lower percentage of previous conception and live birth, a higher percentage of current smokers, a lower percentage of current alcohol users, and higher total testosterone, fasting insulin, and homeostasis-model-assessment insulin resistance. The prevalence of women with non–cavity-distorting uterine fibroids was lower in women with PCOS than in those with UI (6.7% vs. 12.4%); this result held after patients were divided into Black and non-Black or into three different body mass index groups. After adjustment for all the other variables in the final model, patients with PCOS had a significantly lower prevalence of fibroids than those with UI (odds ratio 0.54). No differences in the prevalence of non–cavity-distorting fibroids with any dimensions ≥4 cm or the volume of the largest fibroid was found between the two groups.

Conclusion(s)

A lower prevalence of non–cavity-distorting uterine fibroids was found in infertile women with PCOS than in those with UI.


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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