Open myomectomy with microsurgical principles in infertile patients

Objective: To review pregnancy rates after open myomectomy and evaluate the influence of microsurgical principles. Methods: We reviewed 90 patients with infertility who underwent open myomec tomy. Nineteen of these patients underwent surgery following microsurgical principles outlined by Swolin. Results: The overall postoperative pregnancy rate was 36%. The pregnancy ra te in patients with a morphologically normal uterurs was 43% after myomecto my but 25% to 19% in patients with adhesions, tubal occlusion or endometrio sis, respectively. The pregancy rate in patients with marked intraoperative blood loss was 24%. The pregnancy rate in patients operated on following m icrosurgical principles was 47%. Conclusion: These results suggest that microsurgical principles with gentle tissue handling at myomectomy have a favorable effect on postoperative pre gnancy rates.