A 30-year-old nulliparous woman with primary infertility is found to have a single 3 cm submucosal fibroid (FIGO Type 1) on saline infusion sonography. No other cause of infertility is identified. Which fibroid type has the greatest adverse impact on fertility and miscarriage rates?
- A Submucosal fibroid (FIGO Type 0, 1, or 2) ✓
- B Intramural fibroid (FIGO Type 4)
- C Subserosal fibroid (FIGO Type 5)
- D Pedunculated subserosal fibroid (FIGO Type 7)
Correct answer: A. Submucosal fibroid (FIGO Type 0, 1, or 2)
Explanation
Submucosal fibroids (FIGO Types 0, 1, and 2) have the most significant adverse impact on fertility and miscarriage rates. They distort the endometrial cavity, impair implantation, and alter uterine contractility. Hysteroscopic myomectomy improves fertility outcomes. Intramural fibroids that do not distort the cavity have a lesser effect. Subserosal fibroids have no significant impact on fertility.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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