Gynäkologie und Geburtshilfe
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Abstrakt

Abdominal Myomectomy Increases Fertility Outcome

Surekha Machupalli, Edward P Norkus, Trishit K Mukherjee and Kevin D Reilly

Objective: The aim of this study was to assess fertility outcome after abdominal myomectomy and to examine the influence of the number, size, and location of uterine fibroids pertaining to fertility outcome after the surgery.

Study design: Retrospective clinical study.

Patients and methods: Fertility outcome from 178 women who had abdominal myomectomy during 2000-2004 were analyzed. Data from women with unexplained infertility were collected from medical records and from survey interviews of all women participants.

Main outcome measures: Conception rate, pregnancy loss, and live birth rate after myomectomy were measured. The relationship of size and location of fibroids to fertility outcome was also evaluated.

Results: Conception rate was determined after myomectomy. The percentage of total pregnancies after myomectomy was 58% and spontaneous abortion rate was 45%. Age, number of fibroids removed, and indication for surgery predicted post-myomectomy fertility.

Conclusions: Our study suggests that abdominal myomectomy might improve reproductive outcome in patients with myomas. The reproductive performance was particularly good when the patients were younger and had previous pregnancies prior to the surgery. Myomectomy is associated with less miscarriage rate after pregnancy, compared to those prior to the surgery.