Abstract
Introduction Uterine myoma occurs in 20-50% of reproductive age women. Uterine myomas may be associated with 5-10% of cases of infertility, but it is the sole cause or factor in only 2-3% of all infertility cases. Myomectomy is surgery done to remove myoma regardless of the methods. Objective To assess impact of myomectomy on pregnancy rate and associated factors among reproductive age women who had myomectomy at St. Paul's Hospital Millennium Medical College, in Addis Ababa. Methodology. Hospital-based retrospective cross-sectional study was conducted to determine pregnancy rate after myomectomy and its associated factors. Patients who had myomectomy in SPHMMC from September 2012 to September 2017 were enrolled. Information was retrieved from hospital records and phone interviews with the patients. The strength of statistical association was measured by adjusted odds ratios and 95% confidence intervals. Statistical significance was declared at p value < 0.05. Result Among 180 females participated in this study, 52.2% got pregnant after myomectomy. The result showed that females with age > 35 years were 0.31 times less likely to get pregnant after surgery than those ages 20-25 years [AOR = 0.31 (95% CI: 0.29-0.54)]. People with no infertility before surgery were 1.19 times more likely to be pregnant after surgery than those with unexplained infertility before the surgery [AOR = 1.19 (95% CI: 1.06-1.57)]. People with two uterine incisions were 0.06 times less likely [AOR = 0.06 (95% CI: 0.043-0.51)] while those with three or more than three incisions were 0.02 times less likely [AOR = 0.02 (95% CI: 0.002-0.22)] to get pregnant compared with those with one incision on uterine wall. Conclusion Age, number of incision, and infertility before surgery were significantly associated with rate of pregnancy after myomectomy.
Highlights
Uterine myoma occurs in 20-50% of reproductive age women
Even though myomectomy is the recommended treatment for symptomatic myomas among women wishing to preserve their fertility, the fertility performance of the women after this surgery is not International Journal of Reproductive Medicine thoroughly studied and detailed. It may be associated with infertility due to extensive adhesion causing tubal blockage and intrauterine adhesions (IUAs) if endometrium is breached during surgery [1,2,3]
Our study finding was lower than a study done in the UK which found that 57% pregnancy rate after myomectomy [3]; the finding from the USA found the same result as the UK finding which 57% pregnancy rate was after surgery [15]
Summary
Uterine myoma occurs in 20-50% of reproductive age women. Uterine myomas may be associated with 5-10% of cases of infertility, but it is the sole cause or factor in only 2-3% of all infertility cases. Uterine myoma is a monoclonal, benign tumor arising from smooth muscles of the uterus It occurs in 20-50% of reproductive age women and can be identified by ultrasound in approximately 80% of African-American and 70% of white American women by the time they reach menopause [1,2,3]. Even though myomectomy is the recommended treatment for symptomatic myomas among women wishing to preserve their fertility, the fertility performance of the women after this surgery is not International Journal of Reproductive Medicine thoroughly studied and detailed It may be associated with infertility due to extensive adhesion causing tubal blockage and intrauterine adhesions (IUAs) if endometrium is breached during surgery [1,2,3]
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