Pregnancy outcome after laparoscopic and laparoconverted myomectomy

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Gynecologic Oncology

Background:

• Uterine fibroids (leiomyomas) are common benign tumors affecting women of reproductive age.
• Myomectomy is the surgical removal of fibroids, preserving the uterus for fertility.
• Laparoscopic myomectomy is increasingly preferred over open surgery due to potential benefits.

Purpose of the Study:

• To compare fertility and pregnancy outcomes between laparoscopic myomectomy and myomectomy requiring conversion to laparotomy.
• To evaluate pregnancy-related complications in both surgical groups.

Main Methods:

• Retrospective analysis of 106 infertile women with uterine leiomyomas.
• Comparison of outcomes between 88 women undergoing laparoscopic myomectomy and 18 undergoing laparoconversion.
• Assessment of baseline characteristics, fibroid size, operative time, hospital stay, follow-up duration, pregnancy rates, time to conception, and pregnancy complications.

Main Results:

• No significant difference in baseline characteristics or fibroid number between groups.
• Laparoscopic myomectomy group had significantly smaller largest fibroid diameter (6.2 vs. 8.1 cm) and shorter hospital stay (3.0 vs. 5.5 days).
• Comparable pregnancy rates (48% vs. 56%) and pregnancy-related complication rates were observed, with a shorter time to conception in the laparoscopic group (7.5 vs. 15.1 months).

Conclusions:

• Laparoscopic myomectomy is a feasible and safe surgical option for infertile women with uterine fibroids.
• Fertility and pregnancy outcomes following laparoscopic myomectomy are comparable to those after myomectomy with laparoconversion.
• Laparoscopic myomectomy should be considered for eligible patients due to its benefits, including reduced hospital stay.