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Published on: January 17, 2019
Determinants of pregnancy rate and obstetric outcome after laparoscopic myomectomy for infertility
L Dessolle1, D Soriano, C Poncelet
1Hôpital Hôtel-Dieu de Paris, Paris, France.
Objective:
To determine the effect of myomectomy on infertility and to assess the factors influencing reproductive outcome.
Design:
Retrospective study.
Setting:
Tertiary care center.
Patient(S):
One hundred and three infertile women with uterine leiomyoma who had had infertility >2 years and a follow-up time >12 months were enrolled. Follow-up was complete for 88 patients, including 28 (31.8%) with primary infertility and 44 (50%) with unexplained infertility. The mean (+/-SD) age of the patients was 36.1 +/- 2.1 years.
Intervention(S):
Laparoscopic myomectomy.
Main Outcome Measure(S):
Pregnancy rate according to patient and fibroid characteristics.
Result(S):
Forty-two patients became pregnant (40.7%). The mean (+/-SD) delay in conception was 7.5 +/- 2.6 months. Nearly 80% of the women conceived spontaneously. Of 44 pregnancies in 42 women, 36 live newborns were delivered. No dehiscence of uterine scar occurred. The pregnancy rate was significantly higher in women <35 years of age or <3 years of infertility. Women with unexplained infertility had higher pregnancy rate than did women with multifactorial infertility (P<.001). No difference was noted in pregnancy rates according to fibroid characteristics.
Conclusion(S):
Fertility and pregnancy after laparoscopic myomectomy depend primarily on patient age, duration of infertility before myomectomy, and existence of associated infertility factors.
