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Route of myomectomy and fertility: a prospective cohort study.

Publication ,  Journal Article
Wise, LA; Thomas, L; Anderson, S; Baird, DD; Anchan, RM; Terry, KL; Marsh, EE; Wegienka, G; Nicholson, WK; Wallace, K; Bigelow, R; Spies, J ...
Published in: Fertil Steril
May 2022

OBJECTIVE: To assess prospectively the association between the myomectomy route and fertility. DESIGN: Prospective cohort study. SETTING: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight clinic centers across the United States. PATIENT(S): Reproductive-aged women undergoing surgery for symptomatic uterine fibroids. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): We used life-table methods to estimate cumulative probabilities and 95% confidence intervals (CI) of pregnancy and live birth by the myomectomy route during 12, 24, and 36 months of follow-up (2015-2019). We also conducted 12-month interval-based analyses that used logistic regression to estimate odds ratios and 95% CIs for associations of interest. In all analyses, we used propensity score weighting to adjust for differences across surgical routes. RESULT(S): Among 1,095 women who underwent myomectomy (abdominal = 388, hysteroscopic = 273, and laparoscopic = 434), 202 reported pregnancy and 91 reported live birth during 36 months of follow-up. There was little difference in the 12-month probability of pregnancy or live birth by route of myomectomy overall or among women intending pregnancy. In interval-based analyses, adjusted ORs for pregnancy were 1.28 (95% CI, 0.76-2.14) for hysteroscopic myomectomy and 1.19 (95% CI, 0.76-1.85) for laparoscopic myomectomy compared with abdominal myomectomy. Among women intending pregnancy, adjusted ORs were 1.27 (95% CI, 0.72-2.23) for hysteroscopic myomectomy and 1.26 (95% CI, 0.77-2.04) for laparoscopic myomectomy compared with abdominal myomectomy. Associations were slightly stronger but less precise for live birth. CONCLUSION(S): The probability of conception or live birth did not differ appreciably by the myomectomy route among women observed for 36 months postoperatively. CLINICAL TRIALS REGISTRATION NUMBER: (NCT02260752, clinicaltrials.gov).

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Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

May 2022

Volume

117

Issue

5

Start / End Page

1083 / 1093

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Uterine Myomectomy
  • Prospective Studies
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Male
  • Leiomyoma
  • Humans
  • Fertility
  • Female
 

Citation

APA
Chicago
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Wise, L. A., Thomas, L., Anderson, S., Baird, D. D., Anchan, R. M., Terry, K. L., … Stewart, E. A. (2022). Route of myomectomy and fertility: a prospective cohort study. Fertil Steril, 117(5), 1083–1093. https://doi.org/10.1016/j.fertnstert.2022.01.013
Wise, Lauren A., Laine Thomas, Sophia Anderson, Donna D. Baird, Raymond M. Anchan, Kathryn L. Terry, Erica E. Marsh, et al. “Route of myomectomy and fertility: a prospective cohort study.Fertil Steril 117, no. 5 (May 2022): 1083–93. https://doi.org/10.1016/j.fertnstert.2022.01.013.
Wise LA, Thomas L, Anderson S, Baird DD, Anchan RM, Terry KL, et al. Route of myomectomy and fertility: a prospective cohort study. Fertil Steril. 2022 May;117(5):1083–93.
Wise, Lauren A., et al. “Route of myomectomy and fertility: a prospective cohort study.Fertil Steril, vol. 117, no. 5, May 2022, pp. 1083–93. Pubmed, doi:10.1016/j.fertnstert.2022.01.013.
Wise LA, Thomas L, Anderson S, Baird DD, Anchan RM, Terry KL, Marsh EE, Wegienka G, Nicholson WK, Wallace K, Bigelow R, Spies J, Maxwell GL, Jacoby V, Myers ER, Stewart EA. Route of myomectomy and fertility: a prospective cohort study. Fertil Steril. 2022 May;117(5):1083–1093.
Journal cover image

Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

May 2022

Volume

117

Issue

5

Start / End Page

1083 / 1093

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Uterine Myomectomy
  • Prospective Studies
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Male
  • Leiomyoma
  • Humans
  • Fertility
  • Female