Objective To evaluate the results of abdominal myomectomy for intramu ral and s ubserosal fibroids and to identify factors that influence the reproductive outco me after surgery. Design Retrospective analysis of a case series. Setting An aca demic department specializing in gynecologic surgery. Patient(s) A total of 72 w omen with intramural and subserosal fibroids submitted to abdominal myomectomy w ho wished to conceive after surgery. Intervention(s) Data were collected on clin ical characteristics, surgical features, and obstetric history before and after surgery. Main outcome measure(s) Conception rate, pregnancy loss, and live birth rate before and aft er surgery, as well as postoperative probability of conception according to sele cted clinical and fibroid characteristics. Result(s) Conception rate was 28%bef ore myomectomy and 70%after surgery. The corresponding figures were 69%and 25 %for pregnancy loss and 30%and 75%for live birth rate, respectively. Age < 30 years and number of fibroids removed were the only significant and independent predictors of obstetric outcome by multivariate analysis. Conclusion(s) Our resu lts suggest that abdominal myomectomy might improve reproductive outcome in pati ents with intramural and subserosal fibroids. The reproductive performance was p articularly good when the patientswere younger than 30 years and had a single my oma to remove.
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