Pregnancy outcomes after laparotomic or laparoscopic myomectomy: A multicenter retrospective cohort study.

OBJECTIVE

Expend knowledge about pregnancy rate, live birth rate and outcomes after laparotomic or laparoscopic myomectomy.

METHODS

In four hospitals in the Netherlands patients with a FIGO type 3-7 myoma who underwent laparoscopic or laparotomic myomectomy between January 2007 and April 2022, were retrospectively identified. Indication for the myomectomy was abnormal uterine bleeding, bulk-related symptoms and/or infertility. Baseline characteristics, data of the myomectomy and outcomes including pregnancy rates, live birth rates and complications during pregnancy or delivery, were extracted from electronic patient records. Logistic regression analysis was used to identify factors influencing the live birth rate.

RESULTS

One hundred sixty four patients were included. Sixty one patients had 94 pregnancies after the myomectomy (pregnancy rate: 37 %), resulting in 64 deliveries in 50 patients (30 %). The most common mode of delivery was caesarean section (CS) (n = 40, 62 %). Forty-six patients had a live birth after the myomectomy (live birth rate: 28 %), together they had 60 children. No major complications related to the myomectomy occurred during pregnancy or delivery. Patients who had been pregnant before the myomectomy and patients with infertility as primary symptom, had a higher probability of live birth after myomectomy.

CONCLUSION

Patients who underwent a laparotomic or laparoscopic myomectomy have a live birth rate of 28%, with a pregnancy rate of 37%. The most common mode of delivery is CS. No major complications were found during delivery. Patients with a pregnancy prior to the myomectomy or with infertility as primary symptom had an increased probability of live birth after myomectomy.