Pregnancies following treatment by GnRH-a (Decapeptyl) and myomectomy in infertile women with uterine leiomyomata.
OBJECTIVE
Uterine leiomyomata alone are an infrequent cause of infertility. We presumed that--since the smaller the uterine size at the time of myomectomy, the greater the chances of subsequent conception--diminishing the preoperative tumor size in infertile patients with large leiomyomata prior to myomectomy should be beneficial.


METHODS
Decapeptyl (D-Trp6-LHRH) depot 3.2 mg was administered for a period of 3-6 months to 23 infertile women. No causes of infertility were found in these patients except for uterine leiomyomata. In 10 of the 23 patients conservative myomectomy was added to Decapeptyl treatment.


RESULTS
Following Decapeptyl treatment an average decrease in uterine volume of 57% (range: 22%-86%) was observed in all patients. In ten of the 23 patients conservative myomectomy was added to Decapeptyl treatment resulting in a further 16% decrease in uterine volume. Uterine regrowth following Decapeptyl and myomectomy was found to be significantly lower (P < 0.01) when compared with cases treated with Decapeptyl alone. Five of the ten patients treated by Decapeptyl and myomectomy achieved successful pregnancies and delivered. Among the women treated with Decapeptyl without myomectomy, only one patient conceived.


CONCLUSIONS
From these findings it may be concluded that combined GnRH and myomectomy is the treatment of choice for infertile women with large uterine leiomyomata.
Abramovici
H
H
Department of Obstetrics and Gynecology, Carmel Hospital, Haifa, Israel.
Dirnfeld
M
M
Auslander
R
R
Bornstein
J
J
Blumenfeld
Z
Z
Sorokin
Y
Y
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D007889:Leiomyoma / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D011247:Pregnancy; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D014599:Uterus / Q000187:drug effects / Q000473:pathology
D006728:Hormones; D017329:Triptorelin Pamoate