title: Reproductive outcome following abdominal myomectomy for a very large fibroid uterus.
abstract: The aim of this study was to assess the long-term reproductive outcome following abdominal myomectomy in women with very large fibroid uteri. It is a retrospective study of 90 subfertile women with the main outcome measure of live-birth rate following spontaneous and assisted conception. Mean age of the study population was 37 ± 5 years and mean uterine size was 21 ± 6 weeks. During follow-up (mean 50 ± 10 months), 28 (31%) pregnancies occurred; 18 spontaneous and 10 following IVF. The live-birth rate was 20% and the miscarriage rate was 32%. Multivariate analysis demonstrated that the chance of live birth was significantly reduced with increasing female age at the time of surgery (OR = 0.67, 95% CI 0.51-0.86, p = 0.002). The perioperative blood transfusion rate was 30% and the incidence of major complications was 6%. Fertility after abdominal myomectomy for very large fibroid uteri is possible, and its major determinant is female age at the time of surgery.
authors: Assisted Conception Unit, Guy's and St Thomas NHS Foundation Trust , London , UK.
authors: J
authors: J
authors: Pundir
authors: J
authors: J
authors: Kopeika
authors: L
authors: L
authors: Harris
authors: N
authors: N
authors: Krishnan
authors: C
authors: C
authors: Uwins
authors: A
authors: A
authors: Siozos
authors: Y
authors: Y
authors: Khalaf
authors: T
authors: T
authors: El-Toukhy
mesh_terms: D000328:Adult; D001723:Birth Rate; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Abdominal myomectomy; fertility; large fibroid uterus; live birth; reproductive outcome