The role of leiomyomas in infertility.
OBJECTIVE
To assess the role of leiomyomas and their surgical removal on pregnancy rates.


METHODS
(Canadian Task Force classification II-1). Setting. Academic center.


METHODS
Two hundred twelve women who were investigated for infertility.


METHODS
Laparoscopic myomectomy.


RESULTS
Patients were divided according to case control criteria as those who underwent laparoscopic removal of myomas (106) and those who did not (106); both groups were compared with 106 women with unexplained infertility without myomas. Of the 318 women, 83 (26%) became pregnant and delivered live infants. The 44 (42%) who underwent surgical removal of leiomyomas had higher delivery rates than 12 (11%) who did not undergo surgery (p <0.001) and 27 (25%) who did not have myomas (p <0.001). Patients whose myomas were not surgically treated had fewer deliveries than women who did not have myomas (12 vs 27, p <0.002). Fifteen women had spontaneous abortions before week 12: 3 (3%) who had surgery, 10 (9%) who did not have surgery, and 2 (2%) who did not have myomas.


CONCLUSIONS
Laparoscopic myomectomy improved pregnancy rates over nonsurgical management of myomas.
Bulletti
C
C
Center for Special Pelvic Surgery, University of Bologna, Bologna, Italy.
De Ziegler
D
D
Polli
V
V
Flamigni
C
C
D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D007889:Leiomyoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery