OBJECTIVE: To assess the reproductive outcomes after minilaparotomic and laparoscopic myomectomy in patients wishing to conceive. DESIGN: Randomized controlled trial. SETTING: Departments of obstetrics and gynecology of the universities of Catanzaro, Rome, and Florence, Italy. PATIENT(S): One hundred thirty-six women with symptomatic uterine leiomyomas or unexplained infertility. INTERVENTION(S): Laparoscopic and minilaparotomic myomectomy. MAIN OUTCOME MEASURE(S): Pregnancy, abortion, and live-birth rates. RESULT(S): Between the laparoscopic and minilaparotomic groups no difference was observed in cumulative pregnancy, live-birth, and abortion rates, whereas pregnancy and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly higher in the laparoscopic than in the minilaparotomic group. Categorizing the patients according to surgical indication for myomectomy, cumulative pregnancy rate, pregnancy, and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly better after laparoscopic myomectomy in symptomatic patients, whereas all reproductive outcomes were similar between the two groups in patients with unexplained infertility. CONCLUSION(S): Minilaparotomic and laparoscopic myomectomy improves in a similar manner the reproductive outcomes in patients with unexplained infertility, whereas the laparoscopic approach provides the best benefits in fertile patients with symptomatic leiomyomas.
RCT Entities:
OBJECTIVE: To assess the reproductive outcomes after minilaparotomic and laparoscopic myomectomy in patients wishing to conceive. DESIGN: Randomized controlled trial. SETTING: Departments of obstetrics and gynecology of the universities of Catanzaro, Rome, and Florence, Italy. PATIENT(S): One hundred thirty-six women with symptomatic uterine leiomyomas or unexplained infertility. INTERVENTION(S): Laparoscopic and minilaparotomic myomectomy. MAIN OUTCOME MEASURE(S): Pregnancy, abortion, and live-birth rates. RESULT(S): Between the laparoscopic and minilaparotomic groups no difference was observed in cumulative pregnancy, live-birth, and abortion rates, whereas pregnancy and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly higher in the laparoscopic than in the minilaparotomic group. Categorizing the patients according to surgical indication for myomectomy, cumulative pregnancy rate, pregnancy, and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly better after laparoscopic myomectomy in symptomatic patients, whereas all reproductive outcomes were similar between the two groups in patients with unexplained infertility. CONCLUSION(S): Minilaparotomic and laparoscopic myomectomy improves in a similar manner the reproductive outcomes in patients with unexplained infertility, whereas the laparoscopic approach provides the best benefits in fertile patients with symptomatic leiomyomas.
Authors: Aaron K Styer; Susan Jin; Dan Liu; Baisong Wang; Alex J Polotsky; Mindy S Christianson; Wendy Vitek; Lawrence Engmann; Karl Hansen; Robert Wild; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter Casson; Gregory M Christman; Alicia Christy; Michael P Diamond; Esther Eisenberg; Heping Zhang; Nanette Santoro Journal: Fertil Steril Date: 2017-01-12 Impact factor: 7.329
Authors: K Floss; G-J Garcia-Rocha; S Kundu; C S von Kaisenberg; P Hillemanns; C Schippert Journal: Geburtshilfe Frauenheilkd Date: 2015-01 Impact factor: 2.915