Human Reproduction, Vol 12, 1931-1934, Copyright © 1997 by Oxford University Press
E Darai, H Dechaud, JL Benifla, C Renolleau, P Panel and P Madelenat
We report the limits, complications, subsequent fertility and outcome of
pregnancies after laparoscopic myomectomy. From January 1990 to October
1995, 143 patients underwent a first laparoscopic approach to myomectomy. A
total of 41 patients (28.7%) had a laparoconversion (12 cases for a number
of myomata >5, 15 cases for myoma diameter >7 cm, 12 cases for
peroperative haemorrhage and two cases for adenomyosis). Seventy patients
(49%) wished to conceive: 26 had undergone laparoconversion and 44
laparoscopic myomectomy. A total of 19 pregnancies were obtained in 17
patients after laparoscopic myomectomy (38.6%): eight vaginal deliveries,
three Caesarean sections, four miscarriages, two abortions, one ectopic
pregnancy and one therapeutic abortion. The pregnancy rate in patients with
unexplained infertility and with multifactorial infertility was 48.2% and
20% respectively. The mean delay to conception was 11.3 months. No uterine
rupture was noted. Pelvic adhesions were found in the four patients who
underwent second- look procedure. Our preliminary results indicate that
laparoscopic myomectomy is a useful technique.
ARTICLES
Fertility after laparoscopic myomectomy: preliminary results
Service de Gynecologie, Hopital Bichat-Claude-Bernard, Paris, France.
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