Fertility after multiple myomectomy

Purpose. The problem of fertility after Myomectomy is very essential to establish the success of the quality of life of women planning pregnancy. The risk for a patient with myomas is infertility, late abortion, threatened preterm delivery and preterm birth; whereas for a patient with previous myomectomy it is uterine rupture or sterility; the former happens when the layers suture of uterus is not well supported, the latter when the fallopian tubes are damaged because of surgery. The aim is to show a fertility case after an exceptional multiple Myomectomy (37 myomas). Methods. A conservative surgical approach, consisting of laparotomy for the treatment of a great number of myomas, in a 35-year-old non-pregnant woman with a history of previous sterility, metrorrhagia and dysmenorrhea. Myomas were of various size: from 1 to 6 cm and they involved anterior, posterior wall and fundus; 3 were submucosal, 10 interstizial and the remaining ones were subserous. Results. All the myomas weighted 3.190 g. Postoperative course was regular and 13 months after operation, the patients obtained a successful pregnancy with cesarean section at the 39th week. The baby weighted 3.750 g and was born healthy. During caesarean, uterine walls were well supported with no areas of weakness. Conclusions. This case report involves the issue of fertility, when myomas alter both uterine cavity and walls. A skillful operation, after a complete mapping of the fibroids, allows the patient to solve metrorrhagia, pain and sterility too