Journals / Haseki Tıp Bülteni / 2018 / Cilt: 56 - Sayı: 3

Factors Influencing Clinical Pregnancy Rates After Myomectomy Among Infertile Women: A Single Center Retrospective Study

İnfertil Kadınlarda Miyomektomi Sonrası Klinik Gebelik Oranlarını Etkileyen Faktörler: Tek Merkezli Retrospektif Bir Çalışma

Pages
222–227
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It seems that myoma diameter, number, myometrial location, uterine location and method of surgery are not significant factors in predicting pregnancy.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: To determine the clinical pregnancy rates after myomectomy in infertile women who underwent surgery due to myoma uteri and to investigate the clinical factors affecting outcomes.
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Key Findings & Data:Methods: This retrospective single-centered study included infertile patients who underwent intramural and/or subserousal uterine myomectomy in the infertility clinic at our hospital between February 2012 and October 2014.
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Conclusion & Impact:It seems that myoma diameter, number, myometrial location, uterine location and method of surgery are not significant factors in predicting pregnancy.
🔬Design:Research Article
📍Scope:2012 Verileri
⚙️Variables:Domain Parameters

Abstract

Aim: To determine the clinical pregnancy rates after myomectomy in infertile women who underwent surgery due to myoma uteri and to investigate the clinical factors affecting outcomes. Methods: This retrospective single-centered study included infertile patients who underwent intramural and/or subserousal uterine myomectomy in the infertility clinic at our hospital between February 2012 and October 2014. Data were obtained from the hospital records and patients’ files. Age, body mass index, physical features of myomas (diameter, number, structure, and location), surgical treatment methods used and postoperative pregnancy status were recorded for each patient separately. Results: A total of 211 infertile women who met the inclusion criteria for this study and who underwent myomectomy due to myoma uteri were included. The mean myoma diameter was 7.3±4.4 cm and intramural tumors (49.8%) were the most commonly observed type. Laparoscopic myomectomy was performed in 186 patients (88.1%) and laparoscopic in 25 patients (11.9%). The clinical pregnancy rate was calculated as 19.9% (42/211), while 28.6% (12/42) of pregnancies resulted in live birth and 71.4% (30/42) in spontaneous abortion. The mean age of the pregnant and non-pregnant patients was 33.2±5.6 and 36.8±5.8 years, respectively. The mean body mass index was 25.9±3.5 and 28.8±4.8 kg/m2 , respectively (p 0.05) Conclusion: The most important factors for predicting pregnancy in patients who undergo surgery due to myoma and infertility are female age and body mass index. It seems that myoma diameter, number, myometrial location, uterine location and method of surgery are not significant factors in predicting pregnancy.

Özet

Amaç: Miyoma uteri nedeniyle opere edilen infertil kadınların miyomektomi sonrası klinik gebelik oranlarını belirlemek ve buna etki eden klinik faktörleri araştırmaktır. Yöntemler: Retrospektif tek merkezli olarak tasarlanan bu çalışmaya Şubat 2012-Ekim 2014 tarihleri arasında hastanemizin infertilite kliniğinde intramural ve/veya subseröz yerleşimli uterin miyom nedeniyle miyomektomi operasyonu yapılan infertil hastalar dahil edildi. Hastalarla ilgili veriler hastane kayıtlarından ve hasta dosyalarından elde edildi. Yaş, vücut kitle indeksi, miyom çapı, sayısı, yapısı, yerleşim yeri, uygulanan cerrahi tedavi yöntemi ve operasyon sonrası gebelik durumu her bir hasta için ayrı olmak üzere kaydedildi. Bulgular: Bu çalışmaya belirlenen kriterleri sağlayan ve miyoma uteri nedeniyle miyomektomiye giden toplam 211 infertil kadın dahil edilmiştir. Ortalama miyom çapı 7,3±4,4 cm iken en sık intramural yerleşimli (%49,8) miyomlar izlenmiştir. Hastaların 186’sında (%88,1) miyomektomi laparatomik yöntemle, 25’inde (%11,9) laparoskopik olarak gerçekleştirilmiştir. Klinik gebelik oranı %19,9 (42/211) olarak hesaplanırken, gebeliklerin %28,6’sı (12/42) canlı doğum ile %71,4’ü (30/42) spontan düşük ile sonuçlanmıştır. Gebe kalan ve kalamayan hastaların ortalama yaşı sırasıyla 33,2±5,6 ve 36,8±5,8 yıl (p 0,05) Sonuç: Miyom ve infertilite nedeniyle cerrahiye giden hastalarda gebeliği predikte eden en önemli faktör kadının yaşı ve kilosudur. Miyom çapı, sayısı, miyometrial yerleşim, uterin lokalizayon ve ameliyat tipinin önemli olmadığı görülmektedir.

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Cite This Article

PEKCAN, M. K., BOSTANCI, E. İ., TOKMAK, A., UYGUR, D. Ş., TAŞCI, Y. (2018). Factors Influencing Clinical Pregnancy Rates After Myomectomy Among Infertile Women: A Single Center Retrospective Study. Haseki Tıp Bülteni, Cilt: 56 - Sayı: 3, 222–227. https://ajindex.com/articles/198999

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References (15)

  1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 2003;188:100-7.
  2. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol 1990;94:435-8.
  3. Olive DL, Pritts EA. Fibroids and reproduction. Semin Reprod Med 2010;28:218-27.
  4. Bendifallah S, Brun JL, Fernandez H. [Myomectomy for infertile women: the role of surgery]. J Gynecol Obstet Biol Reprod (Paris) 2011;40:885-901.
  5. Jin C, Hu Y, Chen XC, et al. Laparoscopic versus open myomectomy--a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2009;145:14-21.
  6. Kaminski P, Gajewska M, Wielgos M, et al. Laparoscopic treatment of uterine myomas in women of reproductive age. Neuro Endocrinol Lett 2008;29:163-7.
  7. Marchionni M, Fambrini M, Zambelli V, Scarselli G, Susini T. Reproductive performance before and after abdominal myomectomy: a retrospective analysis. Fertil Steril 2004;82:154-9.
  8. Saleh S, Issa A. Reproductive outcome after abdominal myomectomy. J Obstet Gynaecol 2000;20:282. Gavai M, Berkes E, Lazar L, et al. Factors affecting reproductive outcome following abdominal myomectomy. J Assist Reprod Genet 2007;24:525-31.
  9. Desai P, Patel P. Fibroids, infertility and laparoscopic myomectomy. J Gynecol Endosc Surg 2011;2:36-42.
  10. Çinar M, Tokmak A, Güzel AI, et al. Association of clinical outcomes and complications with obesity in patients who have undergone abdominal myomectomy. J Chin Med Assoc 2016;79:435-9.
  11. Kotani Y, Tobiume T, Fujishima R, et al. Recurrence of uterine myoma after myomectomy: Open myomectomy versus laparoscopic myomectomy. J Obstet Gynaecol Res 2018;44:298-302. Berek JS. Berek and Novak’s gynecology. 15th ed. Lippincott Williams and Willkins, New Delhi; 2012.
  12. Palomba S, Zupi E, Falbo A, et al. A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes. Fertil Steril 2007;88:933-41. Edmonds DK. Dewhurst’s Textbook of obstetrics and gynaecology. 7th ed. Blackwell publishing, USA; 2007. John O. Schorge Williams Gynecology. 1st ed. Dallas, Texas; 2008.
  13. Taylor E, Gomel V. The uterus and infertility. Fertil Steril 2008;89:1-16.
  14. Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 2009;91:1215-23.
  15. Li TC, Mortimer R, Cooke ID. Myomectomy: a retrospective study to examine reproductive performance before and after surgery. Hum Re