Determinants of reproductive outcome after abdominal myomectomy for infertility

Objective: To determine the effect of myomectomy as a therapy for infertility and to define the factors that influence reproductive outcome. Design: Retrospective study of a case series. Setting: An academic department specializing in conservative surgery. Patient(s): A total of 138 infertile women who underwent first-line conservative surgical treatment at laparotomy for uterine leiomyomas over an 8-year period. Intervention(s): Data were collected on baseline clinical characteristics, surgical details, and subsequent reproductive history. Main Outcome Measure(s): Cumulative pregnancy rates at 24 months according to selected clinical and fibroid characteristics. Result(s): Pregnancy occurred in 76 women. The 24-month cumulative probability of conception according to the Kaplan-Meier method was 87% in patients 35 years of age. The pregnancy rates in women with and without minor infertility factors in addition to myomas were 56% and 71%, respectively, and those in women with