Laparoscopic Myomectomy in Infertility Treatment

Leiomyomas (fibroids or myomas) are benign uterine tumors of unknown etiology. Fibroids are most common in women aged between 30 and 40 years, but they can occur at any age. At present, laparoscopic myomectomy is the most appropriate surgical technique for patients with fertility disturbances. We conducted a prospective study, in which a number of 72 patients diagnosed with uterine fibromatosis and infertility were investigated for the impact of laparoscopic myomectomy (i.e. intramural and subserosal fibroids), the fertility rate and the average time for the appearance of pregnancy. The patients were randomly divided into 2 groups: Group 1, consisted of 36 patients with infertility and uterine fibroids associated in which laparoscopic myomectomy it was practiced, and Group 2, consisted of 36 patients, having the same diagnosis who refused surgical ablation. From the 36 patients which were operated, 11 had intramural fibroids and 25 had presented one or more subserosal fibroids (Group 1). The fertility rate was 25% for patients with no surgery (Group 2) comparing with 86.5% for patients with laparoscopic myomectomy (Group 1, 54.5% for patients with intramural fibroids and 32% for patients with subserosal fibroids). The average time of the appearance of the pregnancy was 23 months for the patients which were not operated (Group 2), and 35.2 months for patients with laparoscopic myomectomy (Group 1, 19.2 months for the patients with intramural fibroids and 16 months for the patients with subserosal fibroids). Our study shows that laparoscopic myomectomy improves the fertility rate compared to non-surgical treatment in the case of patients with uterine fibroids and infertility.