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Review
. 2023 Apr 17:10:1151901.
doi: 10.3389/fsurg.2023.1151901. eCollection 2023.

Myomectomy in infertile women: More harm than good?

Antonio Mercorio  1 , Luigi Della Corte  2 , Dominga Boccia  2 , Mario Palumbo  2 , Sabrina Reppuccia  2 , Cira Buonfantino  1 , Lara Cuomo  2 , Maria Borgo  1 , Antonio Zitiello  3 , Maria Chiara De Angelis  1 , Antonio Simone Laganà  4 , Giuseppe Bifulco  1 , Pierluigi Giampaolino  1
Affiliations
Review

Myomectomy in infertile women: More harm than good?

Antonio Mercorio et al. Front Surg. .

Abstract

Adhesion formation following gynecological surgery remains a challenge. The adoption of minimally invasive surgical approaches, such as conventional or robotic-assisted laparoscopy combined with meticulous microsurgical principles and the application of adhesion-reducing substances, is able to reduce the risk of de novo adhesion formation but do not eliminate it entirely. Myomectomy is the most adhesiogenic surgical procedure and postoperative adhesions can have a significant impact on the ability to conceive. Therefore, when surgery is performed as infertility treatment, attention should be paid to whether the benefits outweigh the risks. Among several factors, the size and the location of fibroids are the most accountable factors in terms of adhesion development and post surgical infertility; therefore, the search for effective strategies against adhesion formation in this setting is of paramount importance. The purpose of this review is to evaluate the incidence and factors of adhesion formation and the best preventive measures current available.

Keywords: adhesion; infertility; laparoscopy; myomectomy; uterine fibroids.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Adhesions through the posterior uterine wall and bowel. Sixteen months after laparoscopic myomectomy (Posterior uterine fibroid of 6 cm FIGO 4).
Figure 2
Figure 2
FIGO classification of uterine fibroids according to Munro et al. (2018).
See this image and copyright information in PMC

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