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This retrospective observational study evaluated 94 infertile women undergoing myomectomy before IVF at Sandro Pertini Hospital (2020–2025), stratified by fibroid type and surgical approach. Hysteroscopic myomectomy was used for submucosal lesions, while intramural/subserosal lesions were treated selectively, with IVF outcomes compared to controls without surgery.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-proposed-model-of-a-pragmatic-surgical-approach-in-women-affected-by-uterine-fibroids-undergoing-ivf-a-real-practice-experience/461614/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-proposed-model-of-a-pragmatic-surgical-approach-in-women-affected-by-uterine-fibroids-undergoing-ivf-a-real-practice-experience/461614.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is uterine fibroid management during ART considered challenging?","Question",{"text":113,"@type":114},"Uterine fibroids are common, but treatment effects are not well established. Outcomes may depend on fibroid size, location, and number, and the literature shows controversies and limited shared guidelines.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were patients grouped in this study?",{"text":118,"@type":114},"The study included 94 infertile women with an idiopathic/tubal factor and age under 40. Group A received hysteroscopic myomectomy for submucosal fibroids (FIGO 0–2), group B received open myomectomy for intramural/subserosal fibroids (FIGO 3–8), and group C served as a control group not undergoing myomectomy.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the main IVF outcome differences reported?",{"text":122,"@type":114},"Compared with the control group (C), group B showed statistically significant improvements in implantation rate (31% vs. 12.9%) and clinical pregnancy rate (28.1% vs. 7.8%). 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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nReproductive Physiopatology and Andrology Unit, Sandro Pertini Hospital, 00157 Rome, Italy;  \n[domenico.antonaci@aslroma2.it](domenico.antonaci@aslroma2.it) (D.A.); [roberta.dallalba@aslroma2.it](roberta.dallalba@aslroma2.it) (R.D.);  \n[eleonora.benedetti1993@gmail.com](eleonora.benedetti1993@gmail.com) (E.B.); [andrearago2002@gmail.com](andrearago2002@gmail.com) (A.R.); [laura.antonacii@gmail.com](laura.antonacii@gmail.com) (L.A.);  \n[donatella.miriello@aslroma2.it](donatella.miriello@aslroma2.it) (D.M.); [rocco.rago@aslroma2.it](rocco.rago@aslroma2.it) (R.R.)  \n* Correspondence: [francescogalanti1990@gmail.com](francescogalanti1990@gmail.com); Tel.: +39-3389627701  \nAbstract  \nBackground/Objectives: Uterine fibroids are the most common benign neoplasms of the female genital tract, with a prevalence of 20% to 40% among women of reproductive age. Their management in the context of Assisted Reproductive Technologies (ART) represents a major clinical challenge, characterized by controversies, contrasting approaches, and a lack of shared guidelines. Indeed, the detrimental effects of fibroid treatments are not well known and may be influenced by the size, location, and number of fibroids. The impact of hysteroscopic myomectomy in women affected by submucosal myomas (FIGO classification type: G0–G2) is well documented in the current literature; however, the impact of intramural and subserosal myoma removal (FIGO types 3–8), in particular those \u003C4/5 cm in diameter, remains controversial. The aim of the present study is to introduce and share a pragmatic surgical approach to uterine fibroid management prior to In Vitro Fertilization (IVF), to reduce the knowledge gap regarding uterine fibroid treatment. Methods: We conducted a retrospective observationally study that included 94 cases of infertile women, who underwent myomectomy at our IVF centre at Sandro Pertini Hospital, Rome, Italy, between 2020 and 2025 . These patients met the inclusion criterion of having an idiopathic/tubal factor of infertility and were aged \u003C 40 . We evaluated a group of 17 women (group A) who underwent hysteroscopic myomectomy for submucosal fibroids (FIGO types 0–2) and a group of 39 women (group B) who underwent open (laparotomic) myomectomy for intramural/subserosal fibroids (FIGO types 3–8) . Group B was compared with a control group of 38 women who were similar in terms of all demographic and clinical parameters and myoma features (group C) and did not want to undergo a myomectomy procedure. All surgical procedures were executed by the same expert surgeon following our proposed model: submucosal fibroids were always removed by operative hysteroscopy, while intramural/subserosal fibroids were removed if there were three or more and if they were at least 1 ≥ 3 cm in size. All enrolled patients subsequently underwent IVF treatment at our centre, which consisted of an antagonist protocol for ovarian stimulation, and all transferred embryos were of good quality according to the recent European Society of Human Reproduction and Embryology (ESHRE) classification. Results: In group A, we observed an implantation rate of 41% and a clinical pregnancy rate of 35.2%, and these results are consistent with the current literature. In group B, we obtained statistically si","cbCaiepFW6QYpUms","https://ap.wps.com/l/cbCaiepFW6QYpUms","pdf",1625988,14,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"Why is uterine fibroid management during ART considered challenging?\",\"answer\":\"Uterine fibroids are common, but treatment effects are not well established. Outcomes may depend on fibroid size, location, and number, and the literature shows controversies and limited shared guidelines.\"},{\"question\":\"How were patients grouped in this study?\",\"answer\":\"The study included 94 infertile women with an idiopathic/tubal factor and age under 40. Group A received hysteroscopic myomectomy for submucosal fibroids (FIGO 0–2), group B received open myomectomy for intramural/subserosal fibroids (FIGO 3–8), and group C served as a control group not undergoing myomectomy.\"},{\"question\":\"What were the main IVF outcome differences reported?\",\"answer\":\"Compared with the control group (C), group B showed statistically significant improvements in implantation rate (31% vs. 12.9%) and clinical pregnancy rate (28.1% vs. 7.8%). The live birth rate was also higher in group B, while miscarriage and preterm delivery were lower but not statistically significant.\"}]","A Proposed Model of a Pragmatic Surgical Approach in Women Affected by Uterine Fibroids Undergoing IVF: A “Real Practice” Experience | PDF",1790761976,35]