Abstract
Introduction: Fibroids are the most common benign tumour in women of reproductive age that may cause severe dysmenorrhoea, bleeding, and infertility. There is an increased demand for uterus sparing treatments as more women postpone childbirth to their 30s-40s, when fibroids are more symptomatic. With an increasing choice of treatment options and changing care provider profiles, now is the time to survey current practices and opinions. Endoscopic myomectomy currently represents the standard minimally invasive surgical procedure for treating various fibroids in patients with AUB and reproductive issues being the most common indication.
Aims & Objectives- 1) fate of infertile patient after myomectomy
2) type of surgery for uterine conservation
3) fate of technique used
Material And Method: This retrospective study was carried out on 130 women (age 20-48 yrs) who presented at Rajdeep endoscopy and IVF centre Kota with symptomatic fibroids and infertility.
Results: In our study, maximum incidence of myoma was reported in age group between 20-40 yrs of age and most common fibroids were intramural 38.46 %. Pregnancy rate have reached 50-60% after both laparoscopy and abdominal myomectomy.
Conclusion: In current practice, myomectomy is the most common procedure offered to women seeking to retain their uterus. when performed by an experienced surgeon the procedure is safe and the morbidity is no greater than that of a hysterectomy
Keywords: Myoma, infertility, abnormal uterine bleeding, endoscopic myomectomy.
References
- Walker C, Stewart E. Uterine fibroids: the elephant in the room. Science. 2005;308: 1589-92
- Ezzati M, Norian J, Segers J. Management of uterine fibroids in the patient pursuing assisted reproductive technologies. Womens Health (Lond Engl) 2009;5:413-21.
- Cook H, Ezzati M, Segars J, et al. The impact of uterine leiomyomas on reproductive outcomes. Minerva Ginecol. 2010;62:225–36
- Benecke C, Kruger TF, Siebert TI, Van der Merwe JP, Steyn DW. Effect of fibroids on fertility in patients undergoing assisted reproduction. A structured literature review. Gynecol Obstet Invest. 2005;59:225–30
- Rackow B, Taylor H. Submucosal uterine leiomyomas have a global effect on molecular determinants of endometrial receptivity. Fertil Steril. 2010;93:2027–34]
- Sinclair D, Mastroyannis A, Taylor H. Leiomyoma Simultaneously Impair Endometrial BMP-2-Mediated Deciduali-zation and Anticoagulant Expression through Secretion of TFG-β3. J Clin Endocrinol Metab. 2011;96:412–21.
- Qidwai G, Caughey A, Jacoby A. Obstetric Outcomes in Women with Sonographically Identified Uterine Leiomyomata. Obstet Gynecol 2006; 107:376–382.
- Laughlin S, Baird D, Savitz D, et al. Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy: An Ultrasound-Screening Study. Obstet Gynecol. 2009;113:630–5.
- Sparic R. Uterine myomas in pregnancy, childbirth and the puerperium. Srp Arh Celok Lek. 2014;142(1-2):118–124.
- Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2008;22(4):571–588.
- Duhan N. Current and emerging treatments of uterine myoma- an update. Int J Womens Health. 2011;3:231–241
- Goldberg J, Pereira L. Pregnancy outcomes following treatment for fibroids: uterine fibroid embolization versus laparoscopic myomectomy. Curr Opin Obstet Gynecol. 2006;18:402–406.
- Casini M, Rossi F, Agostini R, et al. Effects of the position of fibroids on fertility. Gynecol Endocrinol. 2006; 22: 106–9.
Corresponding Author
Dr Shalini Gupta
Rajdeep Nursing Home & Infertility Centre
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