***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Several studies have reported that the presence of intramural fibroids affects conception following IVF . We attempted to corroborate or refute the conclusions relating to IVF and leiomyomas of the aforementioned studies . METHODS Women with small intramural leiomyomata ( < or = 5 cm ) discovered on initial pelvic sonographic studies performed in preparation for IVF were prospect ively matched by age , with the next patient of the same age undergoing IVF who did not demonstrate fibroids ( controls ) . RESULTS Though no significant differences were found in outcome when comparing these two groups , there was a distinct trend for lower live delivery rates and higher miscarriage rates . CONCLUSIONS These data support the conclusions of the only other prospect i ve matched control study evaluating similar factors , i.e. that small intramural fibroids can negatively affect IVF outcome . Nevertheless , we think that a multicentre study should be conducted first before evaluating whether myomectomy improves outcome or not BACKGROUND The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown . We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment . METHODS Three-dimensional ( 3D ) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness , uterine pulsatility index (PI)/resistance index ( RI ) , endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index ( VFI ) of endometrial and subendometrial regions .  Smokers , patients with serum estradiol concentrations > or = 20,000 pmol/l on the day of HCG and previous history of myomectomy were excluded . RESULTS Endometrial thickness and pattern , averaged uterine PI and RI and endometrial and subendometrial VI/FI/VFI were similar between the fibroid group and the control group . There was no correlation between the total volume of fibroids and endometrial and subendometrial 3D power Doppler flow indices in the fibroid group . CONCLUSION Endometrial and subendometrial 3D power Doppler flow indices were similar in patients with and without small intramural fibroids BACKGROUND Although uterine fibroids occur in 30 % of women and are associated with a degree of subfertility , the effect of intramural fibroids on the outcome of IVF or ICSI treatment has not been prospect ively studied . METHODS Data were prospect ively collected on 434 women undergoing IVF/ICSI in the assisted conception unit of an inner London teaching hospital . Patients were assessed for the presence of fibroids by transvaginal ultrasound and hysterosonography or hysteroscopy where appropriate . RESULTS During the study period , 112 women with ( study ) , and 322 women without ( controls ) , intramural fibroids were treated . Patients were similar regarding the cause and duration of their infertility , number of previous treatments , and basal serum FSH concentration .  Women in the study group were on average 2 years older ( 36.4 versus 34.6 years ; P < 0.01 ) . There was no significant difference in the duration of ovarian stimulation or gonadotrophin requirement , number of follicles developed , oocytes collected , embryos available for transfer or replaced . When analysing only women with intramural fibroids of < or = 5 cm in size ( n = 106 ) pregnancy , implantation and ongoing pregnancy rates were significantly reduced : 23.3 , 11.9 and 15.1 respectively compared with 34.1 , 20.2 and 28.3 % in the control group ( P = 0.016 , P = 0.018 and P = 0.003 ) . The mean size of the largest fibroids was 2.3 cm ( 90 % range 2.1 - 2.5 cm ) . Logistic regression analysis demonstrated that the presence of intramural fibroids was one of the significant variables affecting the chance of an ongoing pregnancy , even after controlling for the number of embryos available for replacement and increasing age , particularly age > or = 40 years , odds ratio 0.46 ( CI 0.24 - 0.88 ; P = 0.019 ) . CONCLUSION This study demonstrated that an intramural fibroid halves the chances of an ongoing pregnancy following assisted conception PURPOSE Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion . The purpose of this study is to evaluate uterine peristalsis , a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy , in patients with uterine leiomyomas using cine magnetic resonance ( MR ) imaging . MATERIAL S AND METHODS Study population consisted of 26 female patients ( age range : 19 - 51 years , mean : 41 years ) , in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas . We prospect ively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet ( Symphony , Siemens Medical Systems ) with a body array coil , and obtained 60 half-Fourier acquisition single shot turbo spin echo ( HASTE ) images ( Echo time=80 ms , FOV=300 mm , slice thickness 5 mm , matrix 256x256 ) within 2 min , and displayed them on cine mode at 12x faster than real speed . Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements , adjacent to leiomyomas , regarding presence , direction , frequency , and conduction . RESULTS The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas . The frequency and direction were cycle-related . Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients , but was not in others . Focal myometrial movements were noted in 9/16 patients with submucosal myomas , but not in others . CONCLUSIONS Uterine peristaltic movements were partly interrupted by submucosal leiomoymas , but not by myometrial or subserosal leiomyomas . Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas . These findings are considered to represent dysfunctional contractility , and may be related with pregnancy loss STUDY OBJECTIVE To determine the effect of hysteroscopic resection and goserelin in the treatment of submucous fibroids , and their significance in assisted conception . DESIGN Patients with history of subfertility and previous failed attempts at assisted conception were examined by transvaginal sonography before further attempts at assisted conception . Those diagnosed as having submucous fibroids were treated with goserelin injections , hysteroscopic resection , or a combination of both . Saline sonohysterography was performed whenever the submucous nature of the fibroid was unclear . SETTING The Churchill Clinic Fertility and IVF Centre , London , United Kingdom PATIENTS One hundred women being treated for subfertility over a period of 2 years . Twenty-seven had submucous fibroids diagnosed by transvaginal sonography , and a comparable group of 73 had a normal uterine cavity . INTERVENTIONS Three doses of goserelin 3.6 mg subcutaneously at 4-week intervals were given , followed by hysteroscopic resection of the submucous part of fibroids if the fibroids remained submucous . Three patients had hysteroscopic resection without goserelin , as the fibroids were resectable when they were diagnosed . All patients underwent assisted conception within 3 months unless they conceived spontaneously in the interim . MEASUREMENTS AND MAIN RESULTS The pregnancy rate in patients with normal uterine cavity was 26%/embryo transfer , and 15.8 % of these ended in a miscarriage . The pregnancy rate was significantly higher ( p > 0.02 ) in the study group after treatment of submucous fibroids ( 48.2%/embryo transfer ) , and the miscarriage rate of 23.1 % was not significantly different . CONCLUSIONS Submucous fibroids are a significant cause of subfertility . A combination of goserelin injections and hysteroscopic resection significantly improves pregnancy rates without increasing the miscarriage rate 
    Output:
    
The presence of non-cavity-distorting intramural fibroids is associated with adverse pregnancy outcomes in women undergoing IVF treatment