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Comparison of Long-Term Fertility Outcomes after Myomectomy: Relationship with Number of Myomas Removed.

Abstract：

STUDY OBJECTIVE:To determine if the number of myomas removed during myomectomy for symptomatic relief affects long-term fertility outcomes in reproductive-aged women. DESIGN:Retrospective cohort survey study (Canadian Task Force classification II-2). SETTING:University hospital. PATIENTS:One hundred forty-four patients who underwent myomectomy for symptomatic myomas and attempted to conceive afterward. INTERVENTION:Questionnaire mailed to reproductive-aged women who received robotic, laparoscopic, or abdominal myomectomy. MEASUREMENTS AND MAIN RESULTS:Patients with >6 myomas removed were less likely to achieve pregnancy after myomectomy than patients with ≤6 myomas removed (22.9% vs 70.8%, respectively; p < .001). To achieve pregnancy, 45% of those with >6 myomas removed (vs 17.6% of those with ≤6 myomas removed) relied on fertility treatment (clomiphene citrate, letrozole, intrauterine insemination, or in vitro fertilization). Of those with >6 myomas removed who became pregnant, 45.5% had a term birth, 45.5% miscarried, and 9.1% had an ectopic pregnancy. Of those with ≤6 myomas removed who became pregnant, 61.8% had a term birth, 23.5% had a preterm birth, and 13.2% miscarried. CONCLUSION:The number of myomas removed during myomectomy significantly affects fertility. Women with >6 myomas removed were less likely to become pregnant, more likely to require fertility treatment, and less likely to have a term birth when compared with women with ≤6 myomas removed.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Shue S,Radeva M,Falcone T

doi

10.1016/j.jmig.2018.01.016

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

1002-1008

issue

6

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(18)30055-4

journal_volume

25

pub_type

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