[Ability to conceive and the course of pregnancy in women after laparoscopic myomectomy]

Abstract

The aim of the study was to assess fertility of patients after myomectomy. The study included a group of 32 patients, aged 22-41, who underwent laparoscopic myomectomy. Primary infertility was diagnosed in 23 women (71.8%), whereas secondary infertility in 9 women (28.2%). Indications for surgery were rapid growth of myoma during last year and intramural myoma > 3 cm in diameter. The incision of the uterus and removal of myomas was made with harmonic scalpel. The average diameter of the largest myoma was 5.6 cm (range 3-11 cm). The number of myomas observed during operation ranged from 1 to 6. No conversion to laparotomy was performed. The average operation time was 85 min (range 60-185 min). After the operation 13 patients became pregnant, which constitutes 40.6%. Pregnancy ended with birth at term in 9 patients (28.1%), spontaneous abortion occurred in 4 patients (12.5%). Three-dimensional ultrasonography was performed after miscarriage and normal uterine cavity was observed. No obstetric complications were diagnosed in women who conceived. The main conclusions of the study are: 1. Uterine myomas constitute one of the significant causes of infertility and myomectomy using laparoscopy increases the chance of pregnancy. 2. Laparoscopy seems to be a promising and feasible method of myomectomy in women at reproductive age.