Laparoscopic Myomectomy and Pregnancy Outcomes: A Narrative Review

Uterine fibroids (leiomyomas) are common benign tumors in women of reproductive age and are often associated with infertility, heavy menstrual bleeding, and pelvic discomfort. Laparoscopic myomectomy (LSM) has emerged as a fertility-preserving alternative to open surgery, offering faster recovery and reduced perioperative morbidity. This review aims to evaluate the effectiveness of laparoscopic myomectomy in improving pregnancy outcomes among women with fibroid-related infertility. A literature review was conducted using PubMed and Web of Science to identify retrospective cohort studies, case reports, and systematic reviews assessing fertility outcomes after LSM. Data on patient demographics, fibroid characteristics, surgical technique, and reproductive outcomes were extracted and analyzed to assess trends in pregnancy rates, delivery methods, and complications. Fifteen retrospective cohort studies and one case report were included in the analysis. Postoperative pregnancy rates ranged from 44% to 62% across studies, with a high proportion of successful full-term deliveries. Vaginal delivery was feasible in many cases, and complications such as uterine rupture were rare (<1%). Proper suturing techniques and minimally invasive approaches contributed to favorable reproductive outcomes, with LSM proving to be effective even in cases of multiple or large fibroids. Laparoscopic myomectomy is a safe and effective surgical option for women seeking fertility preservation. The procedure is associated with high postoperative pregnancy and live birth rates, minimal complications, and promising obstetric outcomes. Continued advancements in laparoscopic techniques and further large-scale studies with long-term follow-up are needed to refine patient selection and optimize results.