Document Detail


Prognostic factors of reproductive outcome after myomectomy in infertile patients.
MedLine Citation:
PMID:  10920098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to identify the prognostic factors for conception after myomectomy carried out in cases of infertility. A total of 91 infertile patients presenting at least one subserous or intramural myoma measuring >2 cm underwent myomectomy. The characteristics of the patients, myomata and associated infertility factors were collected in a uniform and systematic way. A postal questionnaire was sent to patients. For each of the various factors studied, the specific cumulative probability of spontaneous intrauterine conception was estimated using the Kaplan-Meier method. Multiple regression analysis was then carried out using Cox's proportional hazards model. The cumulative probability of spontaneous intrauterine conception at 2 years follow-up was 44% (95% confidence interval: 32-56%). The cumulative probability of conception was less after removal of a posterior or intramural myoma, after a sutured hysterotomy, and when accompanied by a male factor, associated tubal or ovulation pathology. The cumulative probability of conception was greater after ablation of myomata responsible for menometrorrhagia. The size, deforming effect on the cavity and age played no role in our sample. Our results indirectly suggest that post myomectomy adhesions could have an adverse effect on fertility. Myomata responsible for menometrorrhagia are also the cause of infertility. In the presence of an associated male, tubal or ovulatory factor, the results were poor and it was not possible to determine if a myomectomy should be performed in these cases in order to enhance fertility.
Authors:
A Fauconnier; J B Dubuisson; P Y Ancel; C Chapron
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  15     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-06     Completed Date:  2000-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1751-7     Citation Subset:  IM    
Affiliation:
Service de chirurgie gynécologique (Pr. Dubuisson), Clinique universitaire Baudelocque, CHU Cochin - Saint Vincent de Paul, Paris, France. arnaud.fauconnier@cch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fertilization
Follow-Up Studies
Humans
Infertility, Female / surgery*
Laparoscopy*
Leiomyoma / surgery*
Male
Pregnancy
Regression Analysis
Treatment Outcome*
Uterine Neoplasms / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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