Reproductive performance before and after abdominal myomectomy: a retrospective analysis

Objective: To evaluate the results of abdominal myomectomy for intramural and subserosal fibroids and to identify factors that influence the reproductive outcome after surgery. Design: Retrospective analysis of a case series. Setting: An academic department specializing in gynecologic surgery. Patient(s): A total of 72 women with intramural and subserosal fibroids submitted to abdominal myomectomy who wished to conceive after surgery. Intervention(s): Data were collected on clinical characteristics, surgical features, and obstetric history before and after surgery. Main Outcome Measure(s): Conception rate, pregnancy loss, and live birth rate before and after surgery, as well as postoperative probability of conception according to selected clinical and fibroid characteristics. Result(s): Conception rate was 28% before myomectomy and 70% after surgery. The corresponding figures were 69% and 25% for pregnancy loss and 30% and 75% for live birth rate, respectively. Age <30 years and number of fibroids removed were the only significant and independent predictors of obstetric outcome by multivariate analysis. Conclusion(s): Our results suggest that abdominal myomectomy might improve reproductive outcome in patients with intramural and subserosal fibroids. The reproductive performance was particularly good when the patients were younger than 30 years and had a single myoma to remove. (Fertil Steril(R) 2004;82:154-9. (C)2004 by American Society for Reproductive Medicine.)