Fertility following laparoscopic uterine myomectomy in an infertile patient treated for 10 years. Case report.

The presence of myomas in the uterus is a relevant factor in infertility cases. Myomas may reduce contractility of the uterus, hinder migration of sperm and vascular changes within myomas themselves interfere with embryo implantation. The paper presents the case of a patient with over 10-year-history of infertility treatment diagnosed with numerous myomas of the uterus. The medical records revealed that the patient had undergone laparoscopy and laparotomy due to the left ovarian cyst and had been subjected to hysteroscopic removal of the uterine partition twice. The patient took part in the IVF programme twice--without success. At our Department the patient underwent laparoscopic myomectomy during which 5 myomas were removed: 4 subserous ones, 1.5-2 cm in diameter and an intramural one, 6 cm in diameter. The sites of the biggest myoma were laparoscopically sewn putting in 3 single sutures. In her next cycle the patient spontaneously conceited. The pregnancy was without serious complications and at 38 weeks was terminated by Caesarian section. The infant was delivered in good general condition (10 Apgar points) and weighted 3,360 g. On Caesarian section no uterine dehiscence following laparoscopic myomectomy was observed.