A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes.
OBJECTIVE
To assess the reproductive outcomes after minilaparotomic and laparoscopic myomectomy in patients wishing to conceive.


METHODS
Randomized controlled trial.


METHODS
Departments of obstetrics and gynecology of the universities of Catanzaro, Rome, and Florence, Italy.


METHODS
One hundred thirty-six women with symptomatic uterine leiomyomas or unexplained infertility.


METHODS
Laparoscopic and minilaparotomic myomectomy.


METHODS
Pregnancy, abortion, and live-birth rates.


RESULTS
Between the laparoscopic and minilaparotomic groups no difference was observed in cumulative pregnancy, live-birth, and abortion rates, whereas pregnancy and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly higher in the laparoscopic than in the minilaparotomic group. Categorizing the patients according to surgical indication for myomectomy, cumulative pregnancy rate, pregnancy, and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly better after laparoscopic myomectomy in symptomatic patients, whereas all reproductive outcomes were similar between the two groups in patients with unexplained infertility.


CONCLUSIONS
Minilaparotomic and laparoscopic myomectomy improves in a similar manner the reproductive outcomes in patients with unexplained infertility, whereas the laparoscopic approach provides the best benefits in fertile patients with symptomatic leiomyomas.
Palomba
Stefano
S
Department of Obstetrics & Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
Zupi
Errico
E
Falbo
Angela
A
Russo
Tiziana
T
Marconi
Daniela
D
Tolino
Achille
A
Manguso
Francesco
F
Mattei
Alberto
A
Zullo
Fulvio
F
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D007889:Leiomyoma / Q000601:surgery*; D009215:Myometrium / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D014594:Uterine Neoplasms / Q000601:surgery*