[Fertility following myomectomy by laparotomy in women aged over 38].
OBJECTIVE
Uterine fibroids is the most common benign pathology during reproductive age. Fibroids are implicated as a possible cause of infertility. The mechanism of infertility may depend on the size and the location of the fibroids and remain unclear. Myomectomy is performed in case of symptomatic patients who want to preserve their reproductive potential or in case of infertile patients. There are few data concerning fertility following abdominal myomectomy in patients over the age of 38.


METHODS
Retrospective study of a case series. Assessment of reproductive outcome after abdominal myomectomy among patients older than 38 years.


RESULTS
Abdominal myomectomy was performed on 34 patients aged over 38 during. Among these patients, 25 (74%) were contacted and 15 (60%) tried to obtain a pregnancy. Seven patients (46%) needed a new intervention. Five patients (33%) required intra-uterine insemination or in vitro fertilization and embryo transfer postoperatively. Three patients obtained a pregnancy and two (13%) had a delivery. All pregnancies were obtained spontaneously. None infertile or nulliparous woman before surgery became pregnant postoperatively.


CONCLUSIONS
After 38 years old, nulliparity and infertility before abdominal myomectomy seem to be a factor of poor prognostic to become pregnant after surgery.
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, université Paris-Sud, 157, rue de la Porte-de-Trivaux, 92141 Clamart, France.
I
I
Roux
E
E
Faivre
C
C
Trichot
A-C
AC
Donnadieu
H
H
Fernandez
X
X
Deffieux
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D020883:Hysterotomy / Q000379:methods; D007247:Infertility, Female / Q000453:epidemiology; D007315:Insemination, Artificial; D007889:Leiomyoma / Q000601:surgery*; D013513:Obstetric Surgical Procedures / Q000379:methods*; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*