January 15th, 2021

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Early and Late Pregnancy Rate After Myomectomy Among Women with Symptomatic Uterine Fibroids
Authors:  Michal Mára, M.D., Robert Hudecek, M.D., Elo Obieromah, M.D., Radim Marek, M.D., Jaroslav Klát, M.D., Peter Kašcák, M.D., Borek Sehnal, M.D., Zdenka Lisá, M.D., and Sona Pánková, M.D.
  OBJECTIVE: To determine the number of spontaneously conceived pregnancies achieved during the first and second year after laparoscopic or open myomectomy.

STUDY DESIGN: A multicentric, nonrandomized, prospective clinical study. The study cohort consisted of 392 reproductive-age women with symptomatic intramural uterine fibroids desiring pregnancy who underwent laparoscopic or open myomectomy and were monitored for 2.5 years after surgery. The number and rate of pregnancies during the first and second year after myomectomy were evaluated, and the results between the groups were compared.

RESULTS: During a follow-up period of 2.5 years, no significant difference in total pregnancy rate was recorded in the 2 groups. However, a significantly higher early pregnancy rate was observed with the laparoscopic myomectomy group as compared to the early pregnancy rate among the open myomectomy group (60.3% vs. 44.2%, p=0.006), although there was not a significantly higher late pregnancy rate in the open myomectomy group when compared with the late pregnancy rate among the laparoscopic myomectomy group (22.1% vs. 14.5%, p=0.080).

CONCLUSION: A significantly higher early pregnancy rate exists among patients following laparoscopic myomectomy when compared to the early pregnancy rate among women after an open myomectomy.
Keywords:  fertility; infertility, female; laparoscopic myomectomy; leiomyoma; open myomectomy; pregnancy rate; reproductive techniques; uterine fibroids; uterine neoplasms
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