PREGNANCIES FOLLOWING TREATMENT BY GNRH-A (DECAPEPTYL) AND MYOMECTOMYIN INFERTILE WOMEN WITH UTERINE LEIOMYOMATA

Purpose-Uterine leiomyomata alone are an infrequent cause of infertili ty. We presumed that-since the smaller the uterine size at the time of myomectomy, the greater the chances of subsequent conception-diminish ing the preoperative tumor size in infertile patients with large leiom yomata prior to myomectomy should be beneficial. Procedure-Decapeptyl (D-Trp6-LHRH) depot 3.2 mg was administered for a period of 3-6 months to 23 infertile women. No causes of infertility were found in these p atients except for uterine leiomyomata. In 10 of the 23 patients conse rvative myomectomy was added to Decapeptyl treatment. Findings-Followi ng Decapeptyl treatment an average decrease in uterine volume of 57% ( range: 22%-86%) was observed in all patients. In ten of the 23 patient s conservative myomectomy was added to Decapeptyl treatment resulting in a further 16% decrease in uterine volume. Uterine regrowth followin g Decapeptyl and myomectomy was found to be significantly lower (P < 0 .01) when compared with cases treated with Decapeptyl alone. Five of t he ten patients treated by Decapeptyl and myomectomy achieved successf ul pregnancies and delivered. Among the women treated with Decapeptyl without myomectomy, only one patient conceived. Conclusions-From these findings it may be concluded that combined GnRH and myomectomy is the treatment of choice for infertile women with large uterine leiomyomat a.