The impact of fibroids on fertility is difficult to estimate because there is a high incidence of fibroids in the general population, and the incidence of fibroids increases with age as does infertility. Moreover, many women with fibroids are able to become pregnant without complications. Uterine fibroids are present in approximately 5-10% of infertile patients and have been shown to be an independent factor in 1-2.4% of infertile women. However, uterine fibroids are not considered to be a cause of infertility or a significant influencing factor in infertility without a basic infertility evaluation of the patient and her partner. Interstitial or submucosal fibroids are capable of causing distortion of the uterine cavity morphology or obstruction of the fallopian tube or cervical canal, thus affecting pregnancy and causing pregnancy complications. The pregnancy rate 1 to 2 years after transabdominal myomectomy in patients with unexplained infertility has been reported to be about 40-60%. Studies on the effects of laparoscopic or hysteroscopic myomectomy on fertility have yielded similar results. However, other adjuvant treatment measures for infertility may improve their outcome. Many studies have investigated the effect of fibroids on fertility outcomes after IVF. IVF pregnancy rates are low due to abnormal and distorted uterine cavity morphology caused by uterine fibroids (interstitial or submucosal). In addition, pregnancy rates are significantly improved after submucosal fibroid debulking. Studies have shown no effect of subplasmaline fibroids on fertility outcomes. However, the effect of interstitial myomas on IVF outcomes when they do not cause undistorted distortion of the uterine cavity is unknown. Interstitial fibroids that do not cause distortion of the uterine cavity may have a slight effect on IVF outcomes, but there is no evidence to support routine prophylactic myomectomy before IVF in patients with normal cavity morphology. It is important to note that most studies included patients with 5 cm or smaller myomas and large myomas were excluded. Thus, although distortion of the uterine cavity by fibroids is significantly associated with fertility outcomes, the relationship between fibroid size and pregnancy outcomes needs further study. Some physicians believe that prophylactic myoma debridement is the right choice for patients with large myomas who wish to preserve their reproductive function. For an experienced surgeon, the complications of myomectomy remain low enough to make the procedure feasible, even if the uterus is large. However, the high risk of recurrence after myomectomy makes the procedure less effective. In addition, myomectomy can lead to pelvic adhesions, which can cause tubal obstruction or damage, or even infertility. When evaluating patients with fibroids combined with infertility, there should be a targeted evaluation of the uterus and uterine cavity to assess the site, size and number of fibroids. Data suggest that surgical correction of uterine cavity distortion caused by fibroids should be performed prior to treatment of infertility. In addition, myomectomy should be considered in patients with fibroids after multiple failed IVF cycles, despite normal ovarian response and good follicle quality. Although the impact of uterine fibroids with normal uterine cavity morphology on IVF outcomes is uncertain, there are still many potential detrimental factors.