Reproductive outcome following abdominal myomectomy for a very large fibroid uterus

• Published in: Journal of obstetrics and gynaecology Vol. 35; no. 1; pp. 37 - 41
• Main Authors: Pundir, J., Kopeika, J., Harris, L., Krishnan, N., Uwins, C., Siozos, A., Khalaf, Y., El-Toukhy, T.
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-01-2015; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Abdominal myomectomy; Adult; Birth Rate; Female; fertility; Humans; In vitro fertilization; large fibroid uterus; Leiomyoma - surgery; live birth; Middle Aged; Multivariate analysis; Organ Sparing Treatments - statistics & numerical data; Pregnancy; Pregnancy Outcome; reproductive outcome; Reproductive system; Retrospective Studies; Surgery; Uterine Myomectomy - statistics & numerical data; Uterine Neoplasms - surgery; Women; reproductive outcome; large fibroid uterus; Abdominal myomectomy; live birth; fertility
• ISSN: 0144-3615; 1364-6893
• DOI: 10.3109/01443615.2014.930097

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.