[Uterine fibromyomas: fertility after myomectomy. About 41 cases]

Fibromyomas are among the most frequent pathologies of women in their reproductive years; that's why clinicians studied their impact on fertility especially when no other cause is found. In this retrospective study of 41 infertile patients between January 1996 and December 1999, the authors tried to define the assess of myomectomy in these cases and the relevant factors that influence the post-operative results in terms of fertility. 24 patients were operated by laparotomy, 7 by laparoscopy and 10 by hysteroscopy. Once surgery was performed, 19 women conceived (46.34%) with delays ranging between 3 and 36 months (mean delay: 15.5 months). An age of less than 40, a sterility of less than 5 years duration and the absence of associated factors seems to enhance the chances of these patients to conceive after mytomectomy. No significant difference was noted in terms of subsequent fertility between the group of primary infertility and that of secondary sterility; neither concerning the myomas' number, size or place. Pregnancy rates after surgery were equivalent whether the myomectomy was performed by laparotomy or laparoscopy. It is, then, reasonable to propose to infertile patients with uterine myomas, a conservative surgery especially if they are young and if their sterility is unexplained for less than five years.