Fertility after hysteroscopic myomectomy: effect of intramural myomas associated

Objective: The aims of this retrospective study were to evaluate the subseq uent fertility and outcome of pregnancies after hysteroscopic myomectomy ac cording to (a) the characteristics of submucous myomas and (b) the associat ion with intramural myomas. Materials and methods: From July 1994 to June 1 997, 119 patients had hysteroscopic myomectomy including 31 infertile women . Among these 31 patients, the mean number of removed myomas by hysteroscop y was 1.4 (range 1-4) and the mean diameter of fibroid was 20 mm (range 10 to 50). Results: Eleven out of 31 women (35.5%) became pregnant. Thirteen p regnancies were observed including nine term deliveries, three miscarriages and one premature labor at 24 weeks of amenorrhea. A difference in deliver y rate was found between patients with one submucous myoma resected and tho se with two or more (p=0.02). No difference in pregnancy and in delivery ra tes was observed according to size and location of submucous myomas. In con trast, in patients without intramural myomas, the delivery rate (p<0.03) wa s significantly greater and the delay of conception (p=0.05) was significan tly shorter than those found in patients with intramural myomas. Conclusion : Our study suggest that fertility after hysteroscopic myomectomy depend on (a) the number of submucous myomas resected and (b) the association with i ntramural fibroids. (C) 2000 Elsevier Science Ireland Ltd. All rights reser ved.