Surgery for Fibroids in Infertility Women: The How, the When, and the When Not

Uterine fibroids may impact fertility and the outcomes of infertility treatments negatively, depending on the fibroids' positions in the uterine wall, their sizes, and their numbers. This article reviews the available data on managing uterine fibroids in infertile patients. Subserosal fibroids do not affect fertility negatively and generally do not require treatment. It is advisable to remove submucosal fibroids before infertility treatment or in patients who have recurrent miscarriages. It is challenging to counsel infertile women with intramural fibroids because of the lack of a consensus about what should be done. The choice of treating intramural fibroids depends on the characteristics of the fibroids (such as numbers, sizes, and distances from the endometrial cavity), the reproductive history of the patient, and her willingness to wait until the appropriate time for myometrial healing before receiving infertility treatments. (J GYNECOL SURG 20XX:000)