Objective: To assess the fertility of patients after myomectomy in the Department of Gynecology-Obstetrics of the Yalgado Ouedraogo University Hospital Center from September 1, 2014 to August 31, 2018.
Patients and methods: This was a retrospective cross-sectional descriptive and analytical exposure study with repeated survey and included patients of childbearing age who had undergone myomectomy during the study period; whose myomectomy is at least six (06) months old; having expressed a desire to become pregnant for at least twelve (12) months according to the definition of infertility; and having given their informed consent to the interview.
Results: A total of 102 patients were included in our study. Infertility was primary in 64.71% and secondary in 35.29%. The mean age of the patients was 35.08 ± 5.42 years. Housewives accounted for 37.25%, and married women 66% of patients. After the myomectomy, 44 respondents (43.14%) achieved pregnancy; including 28/66 patients after primary infertility, and 16/36 after secondary infertility. The mean time to conception was 5.63 ± 3.46 months after the start of her postoperative quest. We observed 90.91% live births. Cesarean section was performed in 82.5% of patients and vaginal route in 17.5% of them. The main factors associated with fertility after myomectomy were: young age (p = 0.000), duration of infertility (p = 0.000), normal hysterosalpingography result (p = 0.000) and normal result spermogram of the spouse (p = 0.029).
Conclusion: The relationship between myoma and infertility has not been clearly demonstrated. However, based on our results and given the difficulty of accessing ART, it seems lawful to us to offer myomectomy to patients with infertility associated with myomas, especially in patients under 35 years of age. A larger study would better establish the impact of myomectomy on the subsequent fertility of patients.
Fibromyomas; uterus; myomectomy; post-operative fertility; CHU-Yalgado Ouedraogo; Burkina Faso