Skip to main content
Log in

Reproductive outcome after laparoscopic myomectomy for intramural myomas in infertile women with or without associated infertility factors

  • Original Article
  • Surgery
  • Published:
Reproductive Medicine and Biology

Abstract

Aims

To evaluate reproductive outcome after laparoscopic myomectomy for intramural myomas in infertile women with or without associated infertility factors.

Methods

A retrospective study was carried out in 30 infertile women with intramural myomas measuring ≥50 mm in diameter and treated using laparoscopy.

Results

The overall rate of spontaneous intrauterine pregnancy was 50.0% (15 patients). Of 13 patients with infertility factors associated with the uterine myomas, three (23.1%) became pregnant, whereas 12 of 17 patients (70.6%) with no other associated infertility factor became pregnant. No uterine ruptures were observed. All pregnancies were spontaneous and 13 occurred within 1 year of the operation. In the 10 patients who gave birth by Cesarean section, no adhesions were found on the myomectomy scar.

Conclusions

On the basis of these results, laparoscopic surgery for myomas appears to offer comparable results to laparotomy. In infertile patients with intramural myoma, pregnancy rates are affected by the presence of other infertility factors associated with the uterine myomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Verkauf BS. Myomectomy for fertile enhancement and preservation.Fertil Steril 1992;58: 1–15.

    PubMed  CAS  Google Scholar 

  2. Atlee WL. Case of successful extirpation of a fibrous tumor of the peritoneal surface of the uterus by the large peritoneal section.Am J Med Sci 1844;9: 309–334.

    Google Scholar 

  3. Semm K, Mettler L. New methods of pelviscopy for myomectomy ovariectomy tubectomy and adnexectomy.Endoscopy 1979;11: 85–93.

    PubMed  CAS  Google Scholar 

  4. Nezhat C, Nezhat F, Silfen SL, Schaffer N, Evans D. Laparoscopic myomectomy.Int J Fertil 1991;36: 275–280.

    PubMed  CAS  Google Scholar 

  5. Daniell JF, Guerly LD. Laparoscopic treatment of clinically significant symptomatic uterine fibroids.J Gynecol Surg 1991;7: 37–40.

    Article  Google Scholar 

  6. Hasson HM, Rotman C, Rana N, Sistos F, Dmowski WP. Laparoscopic myomectomy.Obstet Gynecol 1992;80: 884–888.

    PubMed  CAS  Google Scholar 

  7. Dubuisson JB, Lecuru F, Foulot H, Mandelbrot L, Aubriot FX, Mouly M. Myomectomy by laparoscopy: a preliminary report of 43 cases.Fertil Steril 1991;56: 827–830.

    PubMed  CAS  Google Scholar 

  8. Smith DC, Uhlir JK Myomectomy as a reproductive procedure.Am J Obstet Gynecol 1990;162: 1476–1482.

    PubMed  CAS  Google Scholar 

  9. Berkeley AS, De Cherney AH, Polan ML. Abdominal myomectomy and subsequent fertility.Surg Gynecol Obstet 1983;156: 319–322.

    PubMed  CAS  Google Scholar 

  10. Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management.Fertil Steril 1981;36: 433–445.

    PubMed  Google Scholar 

  11. Rosenfeld DL. Abdominal myomectomy for otherwise unexplained infertility.Fertil Steril 1986;46: 328–330.

    PubMed  CAS  Google Scholar 

  12. Lethaby A, Vollenhoven B, Sowter M. Efficacy of pre-operative gonadotrophin hormone releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy: a systematic review.Br J Obstet Gynaecol 2002;109: 1097–1108.

    CAS  Google Scholar 

  13. Morita M, Asakawa Y, Uchiide I, Kubo H. Surgery results using different uterine wall incision directions in laparoscopic myomectomy of intramural myoma.Reprod Med Biol 2004;3: 33–37.

    Article  Google Scholar 

  14. The American Fertility Society. Revised American Fertility Society classification of endometriosis: 1985.Fertil Steril 1985;43: 351–352.

    Google Scholar 

  15. Vercellini P, Naddalena S, De Giogi O, Pesole A, Ferrari L, Crosignani PG. Determinants of reproductive outcome after abdominal myomectomy for infertility.Fertil Steril 1999;72: 109–114.

    Article  PubMed  CAS  Google Scholar 

  16. Dubuisson JB, Chapron C, Chavet C, Gregorakis SS. Fertility after laparoscopic myomectomy of large intramural myomas: preliminary results.Hum Reprod 1996;11: 518–522.

    PubMed  CAS  Google Scholar 

  17. Wallach EE, Vu KK. Myomata uteri and fertility.Obstet Gynecol Clin North Am 1995;22: 791–799.

    PubMed  CAS  Google Scholar 

  18. Diczfalusy E, Crosignani PG. Infertility revisited: the state of the art today and tomorrow.Hum Reprod 1996;11: 1779–1807.

    Google Scholar 

  19. Davids A. Myomectomy. Surgical techniques and results in a series of 1150 cases.Am J Obstet Gynecol 1952;63: 592–604.

    PubMed  CAS  Google Scholar 

  20. Loeffler FE, Noble AD. Myomectomy at the Chelsea Hospital for Women.J Obstet Gynaecol Br Commonw 1970;77: 167–170.

    PubMed  CAS  Google Scholar 

  21. Li TC, Mortimer R, Cooke ID. Myomectomy: a retrospective study to examine reproductive performance before and after surgery.Hum Reprod 1999;14: 1735–1740.

    Article  PubMed  CAS  Google Scholar 

  22. Hunt JE, Wallach EE. Uterine factors in infertility: an overview.Clin Obstet Gynecol 1974;17: 44–64.

    Article  PubMed  CAS  Google Scholar 

  23. Farrer-Brown G, Beilby JOW, Tarbit MH. The vascular patterns in myomatous uteri.J Obstet Gynaecol Br Commonw 1970;77: 967–970.

    PubMed  CAS  Google Scholar 

  24. Dubuisson JB, Chavet X, Chapron C, Gregorakis SS, Morice P. Uterine rupture during pregnancy after laparoscopic myomectomy.Hum Reprod 1995;10: 1475–1477.

    PubMed  CAS  Google Scholar 

  25. Harris WJ. Uterine dehiscence following laparoscopic myomectomy.Obstet Gynecol 1992;80: 545–546.

    PubMed  CAS  Google Scholar 

  26. Friedmann W, Maier RF, Luttkus A, Schafer APD, Dudenhausen JW. Uterine rupture after laparoscopic myomectomy.Acta Obstet Gynecol Scand 1996;75: 683–684.

    Article  PubMed  CAS  Google Scholar 

  27. Pelosi MA III, Pelosi MA. Spontaneous uterine rupture at thirty-three weeks subsequent to previous superficial laparoscopic myomectomy.Am J Obstet Gynecol 1997;177: 1547–1549.

    Article  PubMed  Google Scholar 

  28. Hockstein S. Spontaneous uterine rupture in the early third trimester after laparoscopically assisted myomectomy.J Reprod Med 2000;45: 139–141.

    PubMed  CAS  Google Scholar 

  29. Mecke H, Wallas F, Brocker A, Gertz HP. Pelviskopische Myomenukleation: Technik, Grenzen, Komplikation.Geburtshilfe Frauenheilkd 1995;55: 374–379.

    Article  PubMed  CAS  Google Scholar 

  30. Arcangeli S, Pasquarette MM. Gravid uterine rupture after myolysis.Obstet Gynecol 1997;89: 857.

    Article  PubMed  CAS  Google Scholar 

  31. Lieng M, Istre O, Langebrekken A. Uterine rupture after laparoscopic myomectomy.J Am Assoc Gynecol Laparosc 2004;11: 92–93.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mineto Morita.

About this article

Cite this article

Morita, M., Asakawa, Y. Reproductive outcome after laparoscopic myomectomy for intramural myomas in infertile women with or without associated infertility factors. Reprod Med Biol 5, 31–35 (2006). https://doi.org/10.1111/j.1447-0578.2006.00120.x

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1447-0578.2006.00120.x

Key words

Navigation