Laparoscopic myomectomy and pregnancy outcome in infertile patients

Objective: To assess outcomes and pregnancy-related complications after lap aroscopic myomectomy in infertile patients. Design: Retrospective analysis. Setting: Tertiary care advanced laparoscopic center. Patient(s): Twenty-eight infertile patients with at least one uterine leiom yoma of >5 cm in diameter. Intervention(s): Laparoscopic myomectomy. Main Outcome Measure(s): Occurrence of pregnancy, delivery rate, and pregna ncy-related complications. Result(s): The average size of the myomas removed was 6 cm (range, 4-13.3 c m). None of the procedures were converted to laparotomy. The postoperative rate of intrauterine pregnancy was 64.3% (n = 18), including 1 of 2 patient s who underwent concomitant hysteroscopic myomectomy. Four patients had spo ntaneous abortions and 14 delivered viable term neonates. Six women had a v aginal delivery without complications and 8 had a cesarean section. No ante partum or intrapartum complications were reported. Conclusion(s): Laparoscopic myomectomy can be offered to patients who want to have children and who refuse to undergo an abdominal myomectomy. Patient selection as well as meticulous surgical technique are the key factors in achieving a successful outcome. (Fertil Steril(R) 1999;71:571-4. (C) 1999 b y American Society for Reproductive Medicine.)