The role of leiomyomas in infertility

Study Objective. To assess the role of leiomyomas and their surgical removal on pregnancy rates. Design. (Canadian Task Force classification 11-1). Setting. Academic center. Patients, Two hundred twelve women who were investigated for infertility. Intervention. Laparoscopic myomectomy. Measurements and Main Results. Patients were divided according to case control criteria as those who underwent laparoscopic removal of myomas (106) and those who did not (106); both groups were compared with 106 women with unexplained infertility without myomas. Of the 318 women, 83 (26%) became pregnant and delivered live infants. The 44 (42%) who underwent surgical removal of leiomyomas had higher delivery rates than 12 (11%) who did not undergo surgery (p<0.001) and 27 (25%) who did not ha ve myomas (p<0.001). Patients whose myomas were not surgically treated had fewer deliveries than women who did not have myomas (12 vs 27, p<0.002). Fifteen women had spontaneous abortions before week 12: 3 (3%) who had surgery, 10 (9%) who did not have surgery, and 2 (2%) who did not have myomas. Conclusion. Laparoscopic myomectomy improved pregnancy rates over nonsurgical management of myomas.