Challenges of Laparoscopic Resection of Uterine Fibroids in Infertility

In: ISGE Series · 2014 · pp. 89–101 · doi:10.1007/978-3-319-09662-9_10 · W117336027
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While myomectomy is chosen for women desiring future pregnancies, the fertility outcomes following laparoscopic myomectomy remain inconclusive due to a lack of prospective studies.

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This chapter reviews the relationship between uterine fibroids (leiomyomas) and infertility and discusses laparoscopic myomectomy as a key fertility-preserving surgical option for women with symptomatic or rapidly growing myomas. It summarizes prior retrospective evidence on fertility, pregnancy outcomes, and deliveries after laparoscopic myomectomy, noting that results have been unconvincing, inconclusive, or controversial. A major limitation explicitly highlighted is the lack of appropriate prospective studies to provide clear answers regarding fertility outcomes following laparoscopic myomectomy. The chapter does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Uterine myomas, commonly referred to as fibroids, are by far the most common benign tumors of the female genital tract. The association between uterine fibroids and infertility is still a subject of debate. The anatomical defect to the endometrium caused by uterine fibroids could be a factor for reducing pregnancy rates and increasing miscarriage rates. Surgery remains the cornerstone of treatment for symptomatic or rapidly growing uterine leiomyomas worldwide. Hysterectomy serves as a terminal procedure, while myomectomy and myolysis are treatments of choice for women who desire future pregnancies or otherwise wish to retain their uterus. Since the introduction of the laparoscopic myomectomy technique, several retrospective studies have been conducted on fertility, pregnancy outcome, and deliveries but mostly with unconvincing, inconclusive, or controversial results. The absence of a clear answer to this crucial question of “fertility outcome following laparoscopic myomectomy (LM)” is probably due to the fact that we have not yet conducted appropriate prospective studies to obtain any clear results. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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