FERTILITY AFTER LAPAROSCOPIC MYOMECTOMY - PRELIMINARY-RESULTS

We report the limits, complications, subsequent fertility and outcome of pregnancies after laparoscopic myomectomy. From January 1990 to Oct ober 1995, 143 patients underwent a first laparoscopic approach to myo mectomy, A total of 41 patients (28.7%) had a laparoconversion (12 cas es for a number of myomata >5, 15 cases for myoma diameter >7 cm, 12 c ases for peroperative haemorrhage and two cases for adenomyosis), Seve nty patients (49%) wished to conceive: 26 had undergone laparoconversi on and 44 laparoscopic myomectomy, A total of 19 pregnancies were obta ined in 17 patients after laparoscopic myomectomy (38.6%): eight vagin al deliveries, three Caesarean sections, four miscarriages, two aborti ons, one ectopic pregnancy and one therapeutic abortion, The pregnancy rate in patients with unexplained infertility and with multifactorial infertility was 48.2% and 20% respectively, The mean delay to concept ion was 11.3 months, No uterine rupture was noted, Pelvic adhesions we re found in the four patients who underwent second-look procedure, Our preliminary results indicate that laparoscopic myomectomy is a useful technique.