Fertility and endocrine outcome after robot-assisted laparoscopic myomectomy (RALM)

Abstract

RALM seems to have a favorable impact on the reproductive outcome of young patients with no impact on the ovarian function.

Robot‐assisted laparoscopic myomectomy for deep intramural myomas

“…In this study, the mean number of removed myomas for each case was 3.8 ± 3.5 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. This is greater than the values in other studies (4,7,8,11,12). In general, the more myomas are resected, the greater time required for the surgery.…”

Reproductive outcomes following robotic myomectomy

“…25 A recent Cochrane Systematic Review reported no significant difference in the rate of cesarean section after open and laparoscopic myomectomy (OR 0.59, 95% CI 0.13 to 2.72). 24 The considerably lower rate of cesarean section in our patients may have been influenced by the greater interval of time from the procedure and when they began actively attempting to conceive.…”

“…Cela et al reported that 77.8% of subjects desiring pregnancy were able to conceive and maintain a viable pregnancy after undergoing RALM. 24 Lonnerfors and Persson reported that 15 out of 22 (68.2%) women who actively attempted to achieve pregnancy were successful after removal of deep intramural myomas by RALM. 28 Tusheva et al reported a pregnancy rate of 75% in 16 RALM patients desiring pregnancy.…”

“…20,[22][23] Similarly, the rate of uterine rupture following RALM has been reported anywhere between 0 to 1.1%. 24,25 Since we first began to perform RALM in our institution, we have maintained a database concerning patient outcomes after undergoing this procedure. The objective of this study was to report post-operative fertility rates and pregnancy outcomes of a large series of patients who had a RALM with a single surgeon at Mount Sinai Hospital from June 2006 to May 2013.…”

The Role of Hysteroscopic and Robot-assisted Laparoscopic Myomectomy in the Setting of Infertility

“…59 Endocrinologic evaluation (day 3 follicle stimulating hormone of menstrual cycle and anti-mullerian hormone levels) of young women undergoing RALM have shown preservation of ovarian reserve 6 months after surgery. 61 The largest retrospective study of pregnancy outcomes after RALM in 872 women, found that observed miscarriage rate (19%) was in the range of those reported after LM. 59 Higher preterm delivery rates were significantly associated with greater number of myomas removed and anterior location of the largest incision.…”