Patients’ Age, Myoma Size, Myoma Location, and Interval Between Myomectomy and Pregnancy May Influence the Pregnancy Rate and Live Birth Rate After Myomectomy

Abstract

Objective: To investigate which clinical characteristics will influence the pregnancy rate and live birth rate after myomectomy. Subjects and Methods: Data of clinical characteristics and reproductive outcome from 471 patients who wished to conceive and who underwent abdominal or laparoscopic myomectomy in the Obstetrics and Gynecology Hospital of Fudan University from January 2008 to June 2012 were retrospectively analyzed. Results: Average age in the pregnancy group (30.0 -3.7 years) and the nonpregnancy group (31.2 -4.1 years) was statistically different (P = .000). The diameter of the biggest myoma had a positive relationship with the pregnancy rate when it was < 10 cm (r s = 0.095, P = .039). Abortions before myomectomy, operation type, number, location, and classification of myomas, uterine cavity penetration, and uterine volume seemed not to influence the pregnancy rate (P > .05). The location of the myoma may influence the live birth rate after myomectomy (r s = 0.198, P = .002). Anterior and posterior myomas were associated with higher live birth rates than other locations (P = .001). The average interval between myomectomy and pregnancy was 16.0 -8.7 months, and there was no difference between the abdominal (17.2 -8.6 months) and laparoscopic (15.2 -8.8 months) groups (P = .102). The interval in the live birth group was 15.0 -8.4 months, and that in the non-live birth group was 18.9 -9.3 months; the difference was significant (P = .005). Conclusions: Patients' age, myoma size and location, and interval between myomectomy and pregnancy may influence the pregnancy rate and live birth rate after myomectomy.

Reproductive outcomes following robotic myomectomy

“…15 Conversely, a retrospective cohort study by Zhang et al analyzed the pregnancy live birth rate of 471 patients after either abdominal or laparoscopic myomectomy and reported that larger myomas (greater than 10 cm in size) may lead to earlier detection and intervention, allowing for better pregnancy outcomes. 40 In addition to size, fibroid location is a major factor influencing clinical outcome after RALM. Elements such as precise dissection and suturing is challenging when the myomas have a deep intramural component or are located posteriorly or in the lower uterine segment.…”