The effect of myomectomy on the morphology uterine and tubal factor of infertility

Objective: To compare the incidence of uterine cavity distortion and tuba! factor before and after myomectomy in women with symptomatic uterine fibroids, which are planning pregnancy. Study design: Prospective, unicentric, cohort study. Setting: Department of Gynecology and Obstetrics Masaryk University and University Hospital Brno. Methods: The tracked file consists of 108 patients with intramural or subserous myoma or myomas, which underwent laparoscopic (LM, n = 60. 55.6%) or open (OM. n = 48, 44.4%) myomectomy in the period from 2013 to 2016 at the Department of Gynecology and Obstetrics LF MU and FN Brno. The analysis is focused on the comparison of incidence of uterine cavity distortion and tubal factor using sonohysterosalpingography (sono HSG) or combination of laparoscopy with chromopertubation and ultrasound before and after surgical intervention. Results: The incidence of uterine cavity distortion in patients after myomectomy was significantly lower compared to the original file in patients before myomectomy, and it in both branches of the study (LM and OM), (n1= 37, n2 = 0, p < 0,001). The incidence of tubal factor in patients after myomectomy was insignificantly lower compared to patients before myomectomy, and it in both branches of study, (LM i OM), (n1 = 29, n2 = 20. p = 0.239). Conclusion: Myomectomy in patients with intramural or subserous myoma or myomas significantly decreases the incidence of uterine cavity distortion and unsignificantly decreases tuba! factor without dependence on used laparoscopic or open method.