Determinats of pregnency rate and obstetric outcome after laparoscopic myomectomy for infertility

Objective: To determine the effect of myomectomy on infertility and to assess the factors influencing reproductive outcome. Design: Retrospective study. Setting: Tertiary care center. Patient(s): One hundred and three infertile women with uterine leiomyoma who had had infertility .2 years and a follow-up time .12 months were enrolled. Follow-up was complete for 88 patients, including 28 (31.8%) with primary infertility and 44 (50%) with unexplained infertility. The mean (6SD) age of the patients was 36.1 6 2.1 years. Intervention(s): Laparoscopic myomectomy. Main Outcome Measure(s): Pregnancy rate according to patient and fibroid characteristics. Result(s): Forty-two patients became pregnant (40.7%). The mean (6SD) delay in conception was 7.5 6 2.6 months. Nearly 80% of the women conceived spontaneously. Of 44 pregnancies in 42 women, 36 live newborns were delivered. No dehiscence of uterine scar occurred. The pregnancy rate was significantly higher in women ,35 years of age or ,3 years of infertility. Women with unexplained infertility had higher pregnancy rate than did women with multifactorial infertility (P,.001). No difference was noted in pregnancy rates according to fibroid characteristics. Conclusion(s): Fertility and pregnancy after laparoscopic myomectomy depend primarily on patient age, duration of infertility before myomectomy, and existence of associated infertility factors. (Fertil Sterilt 2001; 76:370–4. ©2001 by American Society for Reproductive Medicine.)