Dr. R. Abinaya, Dr. Sundar Narayanan
Abstract: Background Myomectomy is the recommended treatment for symptomatic uterine fibroids when women wish to preserve their fertility. The role of infertility and intramural fibroids are controversial. The aim of the present study was to assess the infertility results and pregnancy outcome in infertile patients with or without associated infertility factors who underwent laparoscopic myomectomy of large intramural myoma and to assess the safety of laparoscopic myomectomy in infertility patients. Methods 35 infertile patients who underwent laparoscopic myomectomy for intramural fibroid measuring more than 30 mm in diameter were studied from January 2017 to December 2017. Their fertility and pregnancy outcome were studied for 24 months post laparoscopic myomectomy. Results 23 patients became pregnant (65.5 %). The mean delay in conception was 7±2.9 months. Nearly 34.7 % of the women conceived spontaneously, 34.7 % conceived by IUI and the remaining 30.43 % by IVF. Among 23 pregnancies 17 live newborns were delivered. No dehiscence of uterine scar occurred. No difference was noted in pregnancy rates according to patient and fibroid characteristics. Conclusion Woman whose infertility is probably attributable to intramural fibroids will have 65 % chance of conceiving within one year post myomectomy and the pregnancy rate was found to be 76 % for women who had no other associated infertility factors. Patient and fibroid characteristics had no significant role in infertility post myomectomy. Laparoscopic myomectomy hence is a feasible procedure with less morbidity, rapid recovery, and potentially less risk.
Keywords: myomectomy myoma fibroid laparoscopic myomectomy reproductive outcome