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Not yet recruitingNCT07578623MIOUpdated May 11, 2026

The Impact of Myomectomy on IVF Outcomes: A Multicenter Randomized Controlled Trial

An interventional study of Myomectomy in Infertility, In Vitro Fertilization (IVF) and Uterine Myomas, Leiomyomas, or Fibromas, sponsored by Peking Union Medical College Hospital. Not yet recruiting. Open to female participants aged 20 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-05-11.

Sponsored by Peking Union Medical College Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
792
Allocation
Randomized
Ages
20 Years to 40 Years
Sex
Female
01

Study summary

Uterine fibroids are the most common benign tumors of the female reproductive system and are frequently encountered in women of reproductive age. Although many fibroids are asymptomatic, 5%-10% of women with infertility have coexisting fibroids, and in a small proportion fibroids may be the only identifiable cause of infertility. Fibroids may impair fertility by altering uterine anatomy, affecting uterine blood supply, inducing abnormal uterine contractions or endometrial peristalsis, and impairing endometrial receptivity.

The impact of fibroids on fertility depends strongly on their type, size, number, and relationship to the uterine cavity. Submucosal fibroids clearly reduce clinical pregnancy, implantation, and live birth rates and increase miscarriage risk in patients undergoing assisted reproductive technology. In contrast, the effect of intramural fibroids, especially those that do not distort the uterine cavity, remains controversial. Some studies suggest no significant effect on IVF outcomes, whereas others report reduced clinical pregnancy and live birth rates. Evidence also suggests that fibroids located close to the endometrium or measuring ≥4 cm may be more clinically relevant for assisted reproduction.

Current guidelines differ regarding whether infertile women with fibroids should undergo myomectomy before IVF. Chinese expert consensus recommends myomectomy for women preparing for pregnancy when fibroid diameter is ≥4 cm, whereas other international guidelines emphasize individualized management and note the lack of high-quality evidence. Existing studies are limited by small sample size, retrospective design, and inconsistent inclusion criteria. Therefore, whether myomectomy improves IVF outcomes in women with non-cavity-distorting intramural or subserosal fibroids remains uncertain.

Imaging plays an important role in fibroid assessment. Transvaginal ultrasound is widely used because it is inexpensive and accessible, but it has limitations in accurately localizing fibroids and detecting small lesions. Pelvic MRI provides more accurate evaluation of fibroid location, size, and relationship to the myometrium and endometrium, and is particularly useful for study eligibility assessment.

This multicenter randomized controlled trial is designed to evaluate whether myomectomy improves IVF outcomes in infertile women with FIGO type IV, V, or VI uterine fibroids measuring 4-6 cm. The study will compare IVF outcomes between women who undergo myomectomy before IVF and women who proceed directly to IVF without fibroid removal. The main objective is to determine whether surgical removal of these fibroids improves cumulative live birth after IVF.

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Conditions studied

  • Infertility
  • In Vitro Fertilization (IVF)
  • Uterine Myomas, Leiomyomas, or Fibromas
03

In context

Infertility

2,085 studies on the registry are indexed under Infertility; 357 are open to participants now.

This study's planned enrollment of 792 is above the median of 135 across 1,412 interventional studies indexed under Infertility.

Browse Infertility studies →

Lead sponsor

Peking Union Medical College Hospital is the lead sponsor of 1,155 studies on the registry; 475 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
20 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Female patients aged 20 years or older and younger than 40 years.
  • Primary infertility or secondary infertility. Infertility factors may include male partner factors, ovulatory disorders, tubal factors, endometriosis, other non-uterine corpus disease factors, or unexplained infertility.
  • Pelvic MRI indicating intramural fibroids: FIGO type 4-6; the largest fibroid has a maximum diameter of at least 4 cm and less than 6 cm; a total of no more than two fibroids measuring 4-6 cm; fibroids smaller than 4 cm may be disregarded.
  • Meets indications for IVF and is willing to undergo IVF treatment.

Exclusion criteria

Exclusion Criteria:

  • Infertility factors related to diseases of the uterine corpus, including but not limited to adenomyosis, intrauterine adhesions, endometritis, submucosal fibroids, and multiple endometrial polyps. A single endometrial polyp 1 cm or smaller does not require exclusion.
  • Coexisting malignant or borderline tumors of the reproductive system, or other malignant tumors that are untreated or still under treatment.
  • Active pelvic inflammatory disease.
  • Previous cytotoxic therapy or pelvic/abdominal radiotherapy or chemotherapy.
  • Previous surgery of the uterine corpus, including but not limited to myomectomy, uterine wedge resection, uterine artery embolization, tumor coagulation of the uterine corpus such as high-intensity focused ultrasound or electrocoagulation, and hysteroscopic myomectomy. Prior hysteroscopy, diagnostic curettage, or hysteroscopic polypectomy does not require exclusion.
  • Expected inability to complete follow-up.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
792 participants (estimated)

Study arms

  • Experimental
    Intervention arm

    This arm receives myomectomy before IVF.

    Procedure: Myomectomy

  • No intervention
    Control arm

    This arm receives IVF directly without surgical intervention for uterine myomas.

Interventions

  • ProcedureMyomectomy

    Laparoscopic myomectomy is preferred. Abdominal myomectomy is also acceptable. In principle, layered closure with absorbable sutures should be used. If the full thickness of the myometrium is involved, closure should include at least two layers. Intraoperative tubal patency testing must be performed during surgery. If an endometrial polyp is present in a participant undergoing myomectomy, hysteroscopic endometrial polypectomy should be performed during the same operation.

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What researchers measure

Primary outcomes

  1. cumulative live birth rate within 1 year after IVF treatment.

    number of participants with live birth / total number of participants who initiated treatment x 100%.

    Time frame: within 1 year after IVF treatment

Secondary outcomes

  1. Clinical pregnancy rate after IVF

    Visualization of an intrauterine gestational sac by transvaginal ultrasound after embryo transfer, with or without yolk sac, fetal heartbeat, or fetal pole. Calculation: number of clinical pregnancy cycles/number of embryo transfer cycles x 100%.

    Time frame: within 1 year of IVF

  2. Biochemical pregnancy rate after IVF

    a pregnancy state in which blood hCG is positive after embryo transfer but subsequently decreases, and no gestational sac is visualized by ultrasound. Calculation: number of biochemical pregnancy cycles / total number of cycles x 100%.

    Time frame: within 1 year of IVF

  3. Ongoing pregnancy rate after IVF

    Ongoing pregnancy is defined as an IVF pregnancy that progresses to 20 weeks of gestation or beyond. Calculation: number of pregnancy cycles with fetal heartbeat beyond 20 weeks / number of embryo transfer cycles x 100%.

    Time frame: within 1 year of IVF

  4. Miscarriage rate after IVF

    Miscarriage rate is defined as the proportion of pregnancy losses after clinical pregnancy. Calculation: number of miscarriages after clinical pregnancy / total number of clinical pregnancies x 100%.

    Time frame: within 1 year of IVF

  5. Pregnancy-related complications

    These include ectopic pregnancy, preterm birth, premature rupture of membranes, fetal distress, uterine rupture, fibroid degeneration during pregnancy, gestational diabetes mellitus, hypertensive disorders of pregnancy, and other relevant complications.

    Time frame: within 1 year of IVF

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Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Levens ED, Stegmann BJ, Feinberg EC, Larsen FW. Ultrasonographic characteristics of the endometrium among patients with fibroids undergoing ART. Fertil Steril. 2008 Apr;89(4):1005-7. doi: 10.1016/j.fertnstert.2007.03.096. Epub 2007 Jul 26. PubMed 17662279 ↗
  • Yoshino O, Hayashi T, Osuga Y, Orisaka M, Asada H, Okuda S, Hori M, Furuya M, Onuki H, Sadoshima Y, Hiroi H, Fujiwara T, Kotsuji F, Yoshimura Y, Nishii O, Taketani Y. Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Hum Reprod. 2010 Oct;25(10):2475-9. doi: 10.1093/humrep/deq222. Epub 2010 Aug 18. PubMed 20719814 ↗
  • Ng EH, Yeung WS, Ho PC. Endometrial and subendometrial vascularity are significantly lower in patients with endometrial volume 2.5 ml or less. Reprod Biomed Online. 2009 Feb;18(2):262-8. doi: 10.1016/s1472-6483(10)60264-7. PubMed 19192348 ↗
  • Wang Y, Zhu Y, Sun Y, Di W, Qiu M, Kuang Y, Shen H. Ideal embryo transfer position and endometrial thickness in IVF embryo transfer treatment. Int J Gynaecol Obstet. 2018 Dec;143(3):282-288. doi: 10.1002/ijgo.12681. Epub 2018 Oct 8. PubMed 30238667 ↗
  • Gallos ID, Khairy M, Chu J, Rajkhowa M, Tobias A, Campbell A, Dowell K, Fishel S, Coomarasamy A. Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers. Reprod Biomed Online. 2018 Nov;37(5):542-548. doi: 10.1016/j.rbmo.2018.08.025. Epub 2018 Oct 6. PubMed 30366837 ↗
  • Capmas P, Voulgaropoulos A, Legendre G, Pourcelot AG, Fernandez H. Hysteroscopic resection of type 3 myoma: a new challenge? Eur J Obstet Gynecol Reprod Biol. 2016 Oct;205:165-9. doi: 10.1016/j.ejogrb.2016.06.026. Epub 2016 Aug 31. PubMed 27607740 ↗
  • Casini ML, Rossi F, Agostini R, Unfer V. Effects of the position of fibroids on fertility. Gynecol Endocrinol. 2006 Feb;22(2):106-9. doi: 10.1080/09513590600604673. PubMed 16603437 ↗
  • Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org; Practice Committee of the American Society for Reproductive Medicine. Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline. Fertil Steril. 2017 Sep;108(3):416-425. doi: 10.1016/j.fertnstert.2017.06.034. PubMed 28865538 ↗
  • Perez-Lopez FR, Ornat L, Ceausu I, Depypere H, Erel CT, Lambrinoudaki I, Schenck-Gustafsson K, Simoncini T, Tremollieres F, Rees M; EMAS. EMAS position statement: management of uterine fibroids. Maturitas. 2014 Sep;79(1):106-16. doi: 10.1016/j.maturitas.2014.06.002. Epub 2014 Jun 9. PubMed 24975954 ↗
  • Marret H, Fritel X, Ouldamer L, Bendifallah S, Brun JL, De Jesus I, Derrien J, Giraudet G, Kahn V, Koskas M, Legendre G, Lucot JP, Niro J, Panel P, Pelage JP, Fernandez H; CNGOF (French College of Gynecology and Obstetrics). Therapeutic management of uterine fibroid tumors: updated French guidelines. Eur J Obstet Gynecol Reprod Biol. 2012 Dec;165(2):156-64. doi: 10.1016/j.ejogrb.2012.07.030. Epub 2012 Aug 29. PubMed 22939241 ↗
  • Dolmans MM, Isaacson K, Zhang W, Gordts S, Munro MG, Stewart EA, Bourdon M, Santulli P, Donnez J. Intramural myomas more than 3-4 centimeters should be surgically removed before in vitro fertilization. Fertil Steril. 2021 Oct;116(4):945-958. doi: 10.1016/j.fertnstert.2021.08.016. No abstract available. PubMed 34579828 ↗
  • Yan L, Ding L, Li C, Wang Y, Tang R, Chen ZJ. Effect of fibroids not distorting the endometrial cavity on the outcome of in vitro fertilization treatment: a retrospective cohort study. Fertil Steril. 2014 Mar;101(3):716-21. doi: 10.1016/j.fertnstert.2013.11.023. Epub 2014 Jan 11. PubMed 24424367 ↗
  • Christopoulos G, Vlismas A, Salim R, Islam R, Trew G, Lavery S. Fibroids that do not distort the uterine cavity and IVF success rates: an observational study using extensive matching criteria. BJOG. 2017 Mar;124(4):615-621. doi: 10.1111/1471-0528.14362. Epub 2016 Dec 5. PubMed 27921379 ↗
  • Khalaf Y, Ross C, El-Toukhy T, Hart R, Seed P, Braude P. The effect of small intramural uterine fibroids on the cumulative outcome of assisted conception. Hum Reprod. 2006 Oct;21(10):2640-4. doi: 10.1093/humrep/del218. Epub 2006 Jun 21. PubMed 16790615 ↗
  • Sunkara SK, Khairy M, El-Toukhy T, Khalaf Y, Coomarasamy A. The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis. Hum Reprod. 2010 Feb;25(2):418-29. doi: 10.1093/humrep/dep396. Epub 2009 Nov 12. PubMed 19910322 ↗
  • Somigliana E, De Benedictis S, Vercellini P, Nicolosi AE, Benaglia L, Scarduelli C, Ragni G, Fedele L. Fibroids not encroaching the endometrial cavity and IVF success rate: a prospective study. Hum Reprod. 2011 Apr;26(4):834-9. doi: 10.1093/humrep/der015. Epub 2011 Feb 11. PubMed 21317415 ↗
  • Carranza-Mamane B, Havelock J, Hemmings R; REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY COMMITTEE; SPECIAL CONTRIBUTOR. The management of uterine fibroids in women with otherwise unexplained infertility. J Obstet Gynaecol Can. 2015 Mar;37(3):277-285. doi: 10.1016/S1701-2163(15)30318-2. PubMed 26001875 ↗
  • Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009 Apr;91(4):1215-23. doi: 10.1016/j.fertnstert.2008.01.051. Epub 2008 Mar 12. PubMed 18339376 ↗
  • Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005 Jun;48(2):312-24. doi: 10.1097/01.grf.0000159538.27221.8c. No abstract available. PubMed 15805789 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for May 2026; primary completion for Jun 2028, 25 months later.

Of 385 non-industry interventional studies with no phase under Infertility, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 46. This study's planned 25 months is close to that.

Counting every sponsor, half of 416 studies reached it within 24 months; a quarter within 10 and three quarters within 43.

How these figures are worked out, and which studies are left out of them.

Registered
May 5, 2026
First posted
May 11, 2026
StartEst.
May 1, 2026
Primary completionEst.
Jun 1, 2028
CompletionEst.
Jun 1, 2029
Last update
May 11, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07578623
Responsible party
Sponsor
First posted
May 11, 2026
Start date
May 1, 2026 (estimated)
Primary completion
Jun 1, 2028 (estimated)
Completion
Jun 1, 2029 (estimated)
Last update
May 11, 2026

Study contacts

Hanbi Wang, Dr.
Contact
zhw2005@aliyun.com
(+86)(010)69158620
Lan Zhu, Dr.
Contact
zhu_julie@vip.sina.com

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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