Pregnancy outcome after laparoscopic and laparoconverted myomectomy

To compare fertility and pregnancy-related complications after laparoscopic and laparoconverted myomectomy.

Retrospective analysis of 106 infertile women with uterine leiomyomas, of whom 88 women underwent laparoscopic myomectomy and 18 laparoconversion.

There was no difference in the patients' baseline characteristics or the mean number of fibroids between the laparoscopic and laparoconversion groups. The mean (+/-S.D.) diameter of the largest fibroid in the laparoscopic and laparoconversion groups was 6.2+/-1.8 and 8.1+/-1.4 cm, respectively (P<0.001). There was no difference in operating time between the two groups. The hospital stay was shorter in the laparoscopic group: 3.0+/-1 versus 5.5+/-1 days (P<0.001). The mean follow-up in the laparoscopic and laparoconversion groups was 27.3+/-7.0 and 32.0+/-3.1 months, respectively (NS). No difference in the pregnancy rate was noted between the laparoscopic and laparoconversion groups (48 and 56%, respectively). The mean time before conception in the laparoscopic and laparoconversion groups was 7.5+/-2.6 and 15.1+/-2.4 months, respectively (P<0.001). There was no difference between the two groups as regards the rates of pregnancy-related complications and vaginal delivery. No uterine rupture occurred.

Laparoscopic myomectomy is feasible and safe, and should be considered for infertile women with uterine fibroids. Fertility and pregnancy outcomes following laparoscopic myomectomy are comparable with those following myomectomy after laparoconversion.