title: Fertility and endocrine outcome after robot-assisted laparoscopic myomectomy (RALM).
abstract: BACKGROUND
  Laparoscopic myomectomy has recently gained wide acceptance but this procedure remains technically highly demanding and concerns have been raised about the increased blood loss and an higher risk of postoperative uterine rupture of the pregnant uterus.
  
  
  OBJECTIVE
  The aim of the present study is to evaluate the fertility and endocrine outcome in women underwent robot-assisted laparoscopic myomectomy (RALM).
  
  
  METHODS
  Data from 48 RALM performed in our department between the years 2007 and 2011 have been collected. Conception rate, abortion rate, incidence of feto-maternal morbidity or severe pregnancy and labor-related complications were reported; FSH and AMH levels and ultrasound valuation of AFC has been made before and 6 months after operation. Number of cesarean sections and vaginal deliveries were described.
  
  
  RESULTS
  The average age of the patients was 35 years and median Body Mass Index was 23 kg/m(2) (range 18-35 kg/m(2)). Seven women (13%) became pregnant after RALM with eight pregnancies. One pregnancy is actually on going; there were six deliveries with caesarian section and one spontaneous delivery. No spontaneous abortions. No uterine ruptures occurred. No significant modification of ovarian function was found after myomectomy.
  
  
  CONCLUSIONS
  RALM seems to have a favorable impact on the reproductive outcome of young patients with no impact on the ovarian function.
authors: Department of Reproductive Medicine and Child Development, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.
authors: V
authors: V
authors: Cela
authors: L
authors: L
authors: Freschi
authors: G
authors: G
authors: Simi
authors: R
authors: R
authors: Tana
authors: N
authors: N
authors: Russo
authors: P G
authors: PG
authors: Artini
authors: N
authors: N
authors: Pluchino
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000517:prevention & control; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D004703:Endocrine System / Q000502:physiology; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology / Q000517:prevention & control; D007889:Leiomyoma / Q000453:epidemiology / Q000601:surgery*; D009017:Morbidity; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000517:prevention & control; D010053:Ovary / Q000502:physiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D018873:Pregnancy Rate; D012371:Robotics; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000601:surgery*