Our Summary

This research aimed to understand the effects of different surgical procedures on fertility in women who had surgery for uterine fibroids. The study followed over a thousand women for a period of up to three years after surgery. During this time, the researchers noted any pregnancies and live births that occurred.

The surgical procedures examined in the study included abdominal myomectomy, hysteroscopic myomectomy, and laparoscopic myomectomy. The researchers wanted to see if the type of surgery had any impact on the chances of getting pregnant and having a live birth.

The results showed that there was little difference in the chances of getting pregnant or having a live birth for women regardless of the type of surgery they had. This was also true for women who were trying to get pregnant. Therefore, the researchers concluded that the type of surgery did not significantly impact the likelihood of conception or live birth up to three years after the operation.

FAQs

  1. What was the main purpose of this research on myomectomy?
  2. What were the different types of surgical procedures examined in the study and their impact on fertility?
  3. According to the research, does the type of myomectomy surgery impact the chances of getting pregnant or having a live birth?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss fertility preservation options before the surgery. While myomectomy can improve fertility for some women with fibroids, it’s important to have a conversation with your doctor about your reproductive goals and any potential risks to fertility that may be associated with the surgery. This can help you make informed decisions and explore options such as freezing eggs or embryos before the procedure if needed.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic fibroids that are causing pain, heavy menstrual bleeding, pressure on the bladder or bowel, or fertility issues. Myomectomy may be recommended for women who wish to preserve their fertility and have not had success with other treatments such as medication or hormone therapy. Women who have large fibroids or multiple fibroids that are affecting their quality of life may also be candidates for myomectomy. Additionally, women who have fibroids that are causing complications during pregnancy, such as miscarriage or preterm labor, may be recommended myomectomy to improve their chances of a successful pregnancy.

Timeline

Before myomectomy:

  1. Patient experiences symptoms of uterine fibroids such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider, including myomectomy as a surgical option to remove the fibroids.
  4. Patient undergoes pre-operative testing and preparation for the surgery.

During myomectomy:

  1. Patient undergoes myomectomy surgery to remove the fibroids from the uterus.
  2. The type of myomectomy performed (abdominal, hysteroscopic, or laparoscopic) is determined based on the size, location, and number of fibroids.
  3. The surgery is performed under general anesthesia, and the fibroids are removed through small incisions in the abdomen or through the vagina.

After myomectomy:

  1. Patient stays in the hospital for a few days to recover from the surgery.
  2. Patient may experience pain, cramping, and fatigue during the recovery period.
  3. Patient follows post-operative instructions provided by their healthcare provider, including taking pain medication, avoiding strenuous activities, and attending follow-up appointments.
  4. Patient may experience improvements in symptoms such as decreased menstrual bleeding and pelvic pain.
  5. Patient may begin trying to conceive after recovering from the surgery.
  6. Patient undergoes fertility monitoring to track ovulation and increase chances of conception.
  7. Patient may conceive and have a successful pregnancy and live birth after myomectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy include:

  1. What are the potential risks and complications associated with myomectomy surgery?
  2. How long will the recovery process take after myomectomy surgery?
  3. Will my fertility be affected by undergoing a myomectomy procedure?
  4. Are there any alternative treatments or procedures that could be considered for treating my uterine fibroids?
  5. How soon after myomectomy surgery can I start trying to conceive?
  6. Will I need to undergo any fertility testing or monitoring after myomectomy surgery?
  7. Are there any lifestyle changes or precautions I should take after myomectomy surgery to optimize my chances of conception?
  8. What is the success rate of pregnancy and live birth following myomectomy surgery?
  9. Are there any factors that may affect my individual likelihood of conceiving after myomectomy surgery?
  10. Are there any specific follow-up appointments or considerations I should be aware of after myomectomy surgery in relation to my fertility and reproductive health?

Reference

Authors: Wise LA, Thomas L, Anderson S, Baird DD, Anchan RM, Terry KL, Marsh EE, Wegienka G, Nicholson WK, Wallace K, Bigelow R, Spies J, Maxwell GL, Jacoby V, Myers ER, Stewart EA. Journal: Fertil Steril. 2022 May;117(5):1083-1093. doi: 10.1016/j.fertnstert.2022.01.013. Epub 2022 Feb 23. PMID: 35216832