Roux I, Faivre E, Trichot C, Donnadieu A-C, Fernandez H, Deffieux X
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, université Paris-Sud, 157, rue de la Porte-de-Trivaux, 92141 Clamart, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 Apr;40(2):123-9. doi: 10.1016/j.jgyn.2010.09.011. Epub 2010 Nov 2.
Uterine fibroids is the most common benign pathology during reproductive age. Fibroids are implicated as a possible cause of infertility. The mechanism of infertility may depend on the size and the location of the fibroids and remain unclear. Myomectomy is performed in case of symptomatic patients who want to preserve their reproductive potential or in case of infertile patients. There are few data concerning fertility following abdominal myomectomy in patients over the age of 38.
Retrospective study of a case series. Assessment of reproductive outcome after abdominal myomectomy among patients older than 38 years.
Abdominal myomectomy was performed on 34 patients aged over 38 during. Among these patients, 25 (74%) were contacted and 15 (60%) tried to obtain a pregnancy. Seven patients (46%) needed a new intervention. Five patients (33%) required intra-uterine insemination or in vitro fertilization and embryo transfer postoperatively. Three patients obtained a pregnancy and two (13%) had a delivery. All pregnancies were obtained spontaneously. None infertile or nulliparous woman before surgery became pregnant postoperatively.
After 38 years old, nulliparity and infertility before abdominal myomectomy seem to be a factor of poor prognostic to become pregnant after surgery.
子宫肌瘤是育龄期最常见的良性病变。子宫肌瘤被认为是不孕的可能原因之一。不孕的机制可能取决于肌瘤的大小和位置，目前仍不清楚。对于有症状且希望保留生育潜能的患者或不孕患者，可进行肌瘤切除术。关于38岁以上患者行腹部肌瘤切除术后的生育情况，相关数据较少。
对一组病例进行回顾性研究。评估38岁以上患者行腹部肌瘤切除术后的生殖结局。
对34例38岁以上患者进行了腹部肌瘤切除术。在这些患者中，25例（74%）被随访，15例（60%）尝试怀孕。7例患者（46%）需要再次干预。5例患者（33%）术后需要宫内人工授精或体外受精及胚胎移植。3例患者成功怀孕，2例（13%）分娩。所有妊娠均为自然受孕。术前不孕或未生育的女性术后均未怀孕。
38岁以后，腹部肌瘤切除术前未生育和不孕似乎是术后妊娠预后不良的一个因素。
