Reproduction after myomectomy: Comparison of patients with and without second-look laparoscopy

Kubínová, Kristýna; Mára, Michal; Horák, Petr; Kužel, D; Dohnalová, A

doi:10.3109/13645706.2011.573797

Cited by 27 publications

(13 citation statements)

References 18 publications

(20 reference statements)

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“…Although these prospective studies are among the largest reported, they did not consistently adjust for significant confounders such as age, infertility diagnoses, BMI, reproductive characteristics, anti-TPO antibodies, and anti-chlamydial antibodies. Different primary endpoints (clinical pregnancy, pregnancy loss, ongoing pregnancy, and live birth pregnancy) and inadequate sample sizes lend to difficulty in interpreting the variable results of prior studies (2, 14, 15, 17–19). …”

Section: Discussionmentioning

confidence: 99%

Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

Styer

Jin

Liú

et al. 2017

Fertility and Sterility

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Objective To investigate the association of non-cavity distorting uterine fibroids and pregnancy outcomes following ovarian stimulation-intrauterine insemination (OS-IUI) in couples with unexplained infertility. Design Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes following OS-IUI. Setting Reproductive Medicine Network clinical sites Patients Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. Intervention Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins) and treatment was continued for up to four cycles or until pregnancy was achieved. Main outcomes measures Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. Results 102/900(11.3%) participants had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum anti-Mullerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than those without uterine fibroids. Pregnancy loss prior to 12-weeks was more likely in African American women with fibroids compared to non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids respectively. Conclusions No differences were observed in conception and live birth rates in women with non-cavity distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non-cavity distorting fibroids undergoing OS-IUI for unexplained infertility.

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Section: Discussionmentioning

confidence: 99%

Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

Styer

Jin

Liú

et al. 2017

Fertility and Sterility

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“…Furthermore, after abdominal myomectomy 89.29% of patients had de novo adnexal adhesions which might compromise fertility. In the laparoscopic group de novo adnexal adhesions were observed in 10.6% of patients [ 73 ]. Another study also assessed the occurrence of adhesions after laparoscopic myomectomy during a second procedure and found adhesions in only 1.6% of patients (2/121) [ 74 ].…”

Section: Resultsmentioning

confidence: 99%

Plastic and reconstructive uterus operations by minimally invasive surgery? A review on myomectomy

Hirschelmann

2012

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 1:Doc09; ISSN Not Yet Available

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“…In total, 94.50% of them had abdominal and/or pelvic surgery. The risk of postoperative abdominopelvic adhesions following open surgery was found to be 34%, 8 40.6%, 9 and 50%. 10 In our study, the overall risk of adhesions was 45.1%.…”

Section: Discussionmentioning

confidence: 96%

Surgical adhesions among women undergoing laparoscopic gynecological surgery with or without adhesiolysis – prevalence, severity, and implications: retrospective cohort study at a University Hospital

Al-Husban

Elayyan

El-Qudah

et al. 2020

Clin Med�Insights�Reprod�Health

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Objective: To find out the prevalence of adhesions, severity, and their relation to the current clinical scenario and to the type of previous surgery. Methods and Materials: A retrospective study of patients who already had different previous abdominopelvic surgery and subsequently underwent gynecological laparoscopic surgery for various indications. The patients’ clinical and operative notes were reviewed and analyzed. Results: There were 654 procedures performed. The most common indication for the laparoscopic surgery was secondary infertility 23.5%, followed by adnexal lesions 22.0% and primary infertility 19.6%. Intraoperative adhesions were found in 45.3%. Adhesions were deemed relevant to the clinical scenario in 21.3%. Patients who had a previous history of open (traditional) surgery were more likely to be found with adhesions in comparison with patients with history of laparoscopic surgery (odds ratio: 2.7, 95% confidence interval: 1.4–5.3, p = 0.0025). The presence of adhesions was found to be strongly associated with previous abdominopelvic surgery than non-abdominopelvic surgery (odds ratio: 4.3, p = 0.0078, 95% confidence interval: 1.5–12.5). The most common location of the adhesions was abdominal (36.1%), mixed abdominal and pelvic (35.1%), and pelvic adhesions (28.1%). Severe adhesions were found in 36.1%; 13.6% of converted laparoscopy to open surgery was due to adhesions. Cesarean sections were significantly associated with adhesions. Patients who had cesarean sections were more likely to have adhesions than those who had not (odds ratio: 5.7, 95% confidence interval: 3.8–8.6, p < 0.0001). Adhesiolysis was done without complications in 19.6% of patients with adhesions. Conclusion: Adhesions were prevalent in gynecological patients with previous abdominopelvic surgery. They were a significant contributor to the gynecological and reproductive issues. To minimize the risk of postoperative adhesions, laparoscopic approach should be encouraged instead of traditional surgery and rates of cesarean section should be reduced. Further high-quality studies are needed to establish conclusion and practical guidance toward the use of adhesion barriers.

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Reproduction after myomectomy: Comparison of patients with and without second-look laparoscopy

Cited by 27 publications

References 18 publications

Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

Association of uterine fibroids and pregnancy outcomes after ovarian stimulation–intrauterine insemination for unexplained infertility

Plastic and reconstructive uterus operations by minimally invasive surgery? A review on myomectomy

Surgical adhesions among women undergoing laparoscopic gynecological surgery with or without adhesiolysis – prevalence, severity, and implications: retrospective cohort study at a University Hospital

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