National survey of the surgical management of subfertility associated with uterine fibroids which do not distort the uterine cavity

Uterine fibroids which do not distort the uterine cavity are associated with otherwise unexplained subfertility. There is currently no consensus as to their surgical management. Surgical intervention is left to the discretion of the treating gynaecologist. An anonymous postal questionnaire was sent to gynaecologists in the UK with an interest in subfertility to survey current clinical practice. At total of 245 questionnaires were sent out, and 133 (54%) responses were analysed. Over a third of respondents would not intervene to remove a fibroid under any of the specified circumstances. Of the gynaecologists who would intervene, respondents were most likely to intervene in women aged between 30 and 40 years (43%), at a uterine site (36%), sized over 5 cm (10%) and with only one fibroid being present (14%). Without further guidelines and high quality research, it remains difficult to determine the best treatment for these patients.