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By Mayo Clinic staffYour doctor might recommend myomectomy for troublesome fibroids — that is, those in which symptoms are debilitating or interfere with your normal activities — if:
- You plan to bear children.
- Your doctor suspects uterine fibroids might be hindering your fertility.
- You prefer to retain your uterus.
To improve your chance of successful pregnancy
Exactly how fibroids impact infertility and pregnancy outcomes isn't clear. Many women with fibroids have no difficulty getting pregnant and go on to have uncomplicated pregnancies. But if you have fibroids and have been unable to get pregnant or have had repeated miscarriages, your doctor might suggest treatment for your fibroids — after carefully evaluating you for other potential problems.
There's good evidence that when submucosal fibroids — which bulge into the uterine cavity — distort your uterine cavity, they have an adverse effect on fertility and should be removed. But it's less clear what to do for intramural and subserosal fibroids — which develop within your uterine wall or bulge on the outside of your uterus.
Many women do become pregnant after myomectomy. However, reported fertility rates after the procedure vary widely. Several studies reported that about half the women who attempt pregnancy after myomectomy conceive. An analysis that considered pregnancy outcomes found that about two-thirds of the women delivered babies after myomectomy.
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- The Practice Committee of the American Society for Reproductive Medicine. Myomas and reproductive function. Fertility and Sterility. 2008;90(suppl):S125.
- Stovall TG, et al. Myomectomy. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2009.
- Management of uterine fibroids: An update of the evidence. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/uterupdate/uterup.pdf. Accessed Jan. 26, 2009.
- Breech LL, et al. Leiomyomata uteri and myomectomy. In: Rock JA, et al. Te Linde's Operative Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:687.
- Khaund A, et al. Impact of fibroids on reproductive function. Best Practice & Research Clinical Obstetrics and Gynaecology. 2008;22:749.
- Seracchioli R, et al. Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertility and Sterility. 2006;86:159.
- Agdi M, et al. Endoscopic management of uterine fibroids. Best Practice & Research Clinical Obstetrics and Gynaecology. 2008;22:707.
