“Doctor, I’ve been infertile for almost 10 years and I’m planning to go for IVF, but when I had an ultrasound, I found out that I have uterine fibroids, which are rather serious. If I have surgery, I have to wait for two years before I can get pregnant, but I am already 35 years old, I can’t afford to wait for two years, I really don’t know what to do. I don’t know what to do. Can I do IVF without surgery if I have fibroids?” I am not sure what to do. In our center’s outpatient clinic, a patient was asking for help in fear. She was about to undergo in vitro fertilization due to tubal obstruction, and ultrasonography revealed several subplasma fibroids and intermural fibroids in the posterior wall and uterine fundus, with the largest subplasma fibroid being 51×41mm2 and the largest intermural fibroid being 35×26mm2, which did not protrude significantly into the endometrium. After the discovery of the fibroid, we seriously advised the patient and his wife to undergo surgical treatment to remove the fibroid and wait for two years for the uterus to return to normal before proceeding with IVF treatment, otherwise it would be easy to cause uterine rupture. However, as the patient was already 35 years old, the pressure of age forced her to refuse surgical treatment and strongly requested IVF treatment first. We gave the patient IVF treatment with full informed consent, using a long protocol, with one egg retrieved, one fertilized and one embryo transferred, and a single pregnancy has been successfully achieved. However, with uterine fibroids, is it possible to have direct IVF treatment? Uterine fibroids have a certain impact on the implementation and prognosis of IVF technology, especially in the presence of submucosal fibroids and uterine wall fibroids. Super ovulation drugs can lead to the increase in the size of fibroids, accelerate the degeneration of fibroids, and cause fetal miscarriage and preterm delivery after pregnancy. So, what exactly should we do? According to foreign research reports: infertility patients with leiomyosarcoma, undergoing IVF treatment of pregnancy rate in the following order: submucosal leiomyosarcoma 9%, intermural leiomyosarcoma 16%, subplasma leiomyosarcoma 37%. The rate of early embryo miscarriage was 40% for submucosal leiomyomas, 33% for intermural leiomyomas, and 30% for subplasma leiomyomas. Therefore, we should consider surgical management of submucosal and intermural leiomyomas before implementing IVF, while for subplasma leiomyomas that do not affect the endothelium, we can also choose IVF for fertility treatment with full informed consent if we recommend surgery to no avail.