Utility of laparoscopic uterine myomectomy as a treatment for infertility with no obvious cause except for uterine fibroids
Satomi Kameda1, Masafumi Toyoshima2, Kohei Tanaka3, Osamu Fujii3, Shu-Ichi Iida3, Nobuo Yaegashi2, Takashi Murakami4, Kazuhiko Hoshi3
1 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai; Department of Obstetrics and Gynecology, Suzuki Memorial Hospital, Iwanuma, Miyagi, Japan
2 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
3 Department of Obstetrics and Gynecology, Suzuki Memorial Hospital, Iwanuma, Miyagi, Japan
4 Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga, Japan
Dr. Masafumi Toyoshima
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai 980-8574
Source of Support: None, Conflict of Interest: None
Objectives: Uterine fibroids are capable of causing infertility, but there are no definite criteria for which laparoscopic uterine myomectomy (LM) is known to be beneficial. To investigate the usefulness of LM, we examined pregnancy rates in patients with infertility with no obvious cause except for the presence of uterine fibroids.
Materials and Methods: We retrospectively reviewed the clinical records at Suzuki Memorial Hospital between June 2010 and August 2014. We found 60 eligible patients (LM group, 46; non-LM group, 14). The criteria for performing LM were a maximal fibroid diameter of 40 mm or more or the presence of >4 fibroids.
Results: The duration of infertility before the first visit was significantly longer in the LM group; although there was no significant difference in the mean patient age and body mass index. Pregnancy was achieved in 45.7% of patients (21/46) in the LM group and 28.6% (4/14) in the non-LM group. There were no pregnancies in patients with >10 fibroids. The postoperative pregnancy rate in the LM group was comparable to previously reported pregnancy rates.
Conclusions: Our criteria for performing LM in patients with no obvious cause for infertility except for uterine fibroids seem appropriate, especially when the fibroids are large and the number of fibroids is between 4 and 9. However, our results suggest that the effectiveness of LM is low in patients with 10 or more uterine fibroids.