Laparoscopic versus laparotomic myomectomy in infertility management and its pregnancy outcome in Nigeria

Abstract

Uterine leiomyoma is common among black women of reproductive age in Africa and is associated with infertility. Its definitive means of treatment is myomectomy which can be approached by laparoscopy or laparotomy. There is a need to know if any of these two modes of treatment affects the chances of achieving pregnancy or its outcome in women with background infertility. Objective: To assess the proportion of women who achieved pregnancy after laparoscopic and laparotomic myomectomy with background infertility, their pregnancy outcome and a comparison of the two groups. Materials and Method: The study retrospectively reviewed 36 out of 188 women that had either laparoscopic (n=86) or laparotomic myomectomy (n=102) and achieved pregnancy over a period of 30 months. Result: There was pregnancy in 21 out of 86 women that had laparoscopy and 15 among the 102 women that had laparotomic myomectomy. This gave the pregnancy rates of 24.4% and 14.7% respectively. The pregnancy outcome was favourable and similar between the two groups with the laparoscopic group having a lower caesarean delivery rate of 76.2% compared to100% in the laparotomy group. The duration of hospital stay was significantly lower in the laparoscopy group. Conclusion: Laparoscopic or laparotomic myomectomy improves the chances of pregnancy in women with background infertility below 35 years. The laparoscopic group had a significantly lower caesarean section rate and a shorter duration of hospital stay than the laparotomic group, however, both groups had a similar and favourable pregnancy outcome.