Roshan Nikbakht - Fertility Infertility Perinatology Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
Parvin Dorfeshan - Department of Social Medicine, Faculty of Medicine, Ahvaz Jundishapure University of Medical Sciences, Ahvaz,Iran.

Background and Aim : Submucous myomas have negatively effects on fertility. In order to preservefertility, a conservative treatment should be proposed to women wishing pregnancy, especially in thoseyounger patients.Methods : The patient was a 33-year-old woman. She had secondary infertility for 3 years. In vaginalultrasound, a submucous myoma measuring 26 mm ˟ 31 mm with a compressive effect on the anteriorsurface endometrium, was observed. Ovarian reserve was low. The gold standard of myoma treatment issurgical intervention. But, for the following reasons: the adverse effects of surgery on the endometrium(intrauterine adhesion), the patient s refusal to undergo a myomectomy and her request for pregnancy, ourstrategy for treating was to reduce volume of submucous myoma and start the assisted reproductivetechniques (ART) cycle. We administered three courses of Gonadotropin-releasing hormone analogues(GnRHa) and then induced controlled ovarian hyperstimulation. Ovum pick up was done. Finally, wetransferred two embryos (4 and 6 cells).Results : In subsequent patient visits, βhCG was positive after 14 days. At the last patient visit, the heartof the embryo is formed.Conclusion : From this finding, it may be concluded that combined GnRHa and ART is the treatment ofchoice for infertile women with uterine submucous myoma, considering the reduced ovarian reserve andresponse.

Infertility, Myomas, Assisted Reproductive Techniques (ART)