title: Reproductive performance before and after abdominal myomectomy: a retrospective analysis.
abstract: OBJECTIVE
  To evaluate the results of abdominal myomectomy for intramural and subserosal fibroids and to identify factors that influence the reproductive outcome after surgery.
  
  
  METHODS
  Retrospective analysis of a case series.
  
  
  METHODS
  An academic department specializing in gynecologic surgery.
  
  
  METHODS
  A total of 72 women with intramural and subserosal fibroids submitted to abdominal myomectomy who wished to conceive after surgery.
  
  
  METHODS
  Data were collected on clinical characteristics, surgical features, and obstetric history before and after surgery.
  
  
  METHODS
  Conception rate, pregnancy loss, and live birth rate before and after surgery, as well as postoperative probability of conception according to selected clinical and fibroid characteristics.
  
  
  RESULTS
  Conception rate was 28% before myomectomy and 70% after surgery. The corresponding figures were 69% and 25% for pregnancy loss and 30% and 75% for live birth rate, respectively. Age <30 years and number of fibroids removed were the only significant and independent predictors of obstetric outcome by multivariate analysis.
  
  
  CONCLUSIONS
  Our results suggest that abdominal myomectomy might improve reproductive outcome in patients with intramural and subserosal fibroids. The reproductive performance was particularly good when the patients were younger than 30 years and had a single myoma to remove.
authors.affiliation: Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Marchionni
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
authors.forename: Valentina
authors.initials: V
authors.lastname: Zambelli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Scarselli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Susini
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001723:Birth Rate; D005260:Female; D005306:Fertilization; D006801:Humans; D015994:Incidence; D007889:Leiomyoma / Q000601:surgery*; D015999:Multivariate Analysis; D011184:Postoperative Period; D011247:Pregnancy; D012098:Reproduction; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000601:surgery*