Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline

Practice Committee of the American Society for Reproductive Medicine

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

The purpose of this systematic review is to evaluate if uterine myomas impact the likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes in asymptomatic women. There is insufficient evidence to conclude that the presence of myomas reduces the likelihood of achieving pregnancy. However, there is fair evidence that myomectomy (open or laparoscopic) for cavity-distorting myomas (intramural or intramural with a submucosal component) improves pregnancy rates and reduces the risk of early pregnancy loss. There is fair evidence that hysteroscopic myomectomy for cavity-distorting myomas improves clinical pregnancy rates but insufficient evidence regarding the impact of this procedure on the likelihood of live birth or early pregnancy loss. In women with asymptomatic cavity-distorting myomas, myomectomy may be considered to optimize pregnancy outcomes.

Original languageEnglish (US)
Pages (from-to)416-425
Number of pages10
JournalFertility and sterility
Volume108
Issue number3
DOIs
StatePublished - Sep 2017

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

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