Determinants of Reproductive Outcome after Abdominal Myomectomy in Infertile Women

Kim, Jae Duk; Park, Jeong Kuy; Park, Sun Hee; Yang, Mi Ai; Moon, Chang Sik; Cho, Dong Hyu; Kim, Hyun Young; Hwang, Ho Myong; Jang, In Suck; Doo, Jae Kyun

Abstract

OBJECTIVE
To determine the effect of myomectomy as a treatment for infertility and to define the factors that influence reproductive outcomes
MATERIALS AND METHODS
During the period from January 1995 to December 2001, on 39 patients who suffered from infertility and habitual abortion underwent transabdominal myomectomy at the Department of Obstetrics and Gynecology in Chonbuk National University Hospital.
RESULTS
Pregnancy occurred in 31 women. The mean age was 32.3 years. The pregnancy rates in women with or without associated factors in addition to myoma were 55.5% and 71.4%, respectively, and those in women with <2 years versus >2 years of infertility were 73.7% and 55%, respectively. In case of women with myoma on lateral side, pregnancy rate was 33.3%. Considering the size, women with a myoma, 30~50 mm in size had higher pregnancy rate (81.2%). The 24-month cumulative probability of conception was 91% in patients <30 years of age, 55.5% in patients 30~35years of age, and 40% in patients >35 years of age.
CONCLUSION
Our results suggest a benefit of myomectomy in infertile patients. Factors affecting the pregnancy rate after myomectomy in theses patients are the age of the patient, the duration of infertility, the site of myoma, and the size of myoma <50 mm. However, women should be counseled carefully before surgery because the determinants of outcome appear to be independent of treatment.