Abdominal myomectomy and subsequent fertility

The role of myomectomy in subsequent fertility was evaluated. Of 50 patients undergoing myomectomy, 25 subsequently conceived. The most important correlation with subsequent fertility was surgical indication, 68 per cent of the women who underwent exploration for a pelvic mass having conceived, whereas only 16 per cent of women with a normal infertility evaluation conceived. In addition, women more than 30 years of age who became pregnant had fewer and smaller fibroid tumors than those who did not. It is concluded that myomectomy itself may decrease fertility, probably on the basis of adhesion formation and may be unjustified in women with otherwise negative infertility evaluations.