Non-hysteroscopic Myomectomy and Fertility Outcomes: A Systematic Review

ObjectiveTo perform a systematic review of the literature to identify best practices for nonhysteroscopic myomectomy women with myomas who desire future fertility. The focus areas included factors associated conception and pregnancy outcomes after myomectomy, impact surgical route (laparotomic, laparoscopic, incorporation robot assistance), preoperative findings techniques that have an on reproduction.Data SourcesLibrarian-led electronic searches Ovid MEDLINE, Embase, Cochrane CENTRAL databases were performed from inception February 2020. A targeted reference was update original searches.Methods Study SelectionThe participants reproductive age underwent myoma removal surgery through laparotomic or laparoscopic approaches. fertility markers ovarian reserve, clinical rates, outcomes. We quality assessment using National Institutes Health Quality Assessment Tools developed recommendations graded according strength evidence.Tabulation, Integration, ResultsThe initial search identified 2163 studies, which 51 met inclusion criteria. These consisted 11 studies focused 10 examined 30 related intraoperative findings. Overall, younger age, lower number, distortion endometrial cavity improved myomectomy. uterine artery occlusion did not significantly affect rates Adhesion barriers present possible target further research.ConclusionThis study provides insights into patient selection Further research well-designed trials is needed highlight relationships between characteristics (International Federation Gynecology Obstetrics type, location, size)