A 7‑Year Review of Abdominal Myomectomy for Infertile Women in Delta State: Fertility and Obstetric Outcomes

BACKGROUND: Laparoscopic myomectomy for removal of uterine fibroid in resource‑limited settings is cost prohibitive. Open abdominal myomectomy is unarguably more affordable, despite the drawbacks.

OBJECTIVE: The study aimed to determine fertility and obstetric outcomes after an open abdominal myomectomy.

MATERIALS AND METHODS: A retrospective descriptive study that involved the retrieval of medical records, and analysis of the data of women who had open abdominal myomectomy due to uterine fibroid and unexplained infertility, in a private health facility in Abraka, Delta State, Nigeria, from 1 February 2014 to 31 January 2021. The age, duration of infertility, location of fibroid masses within the uterus, history of previous pregnancy, pregnancy after myomectomy, pregnancy outcome and amongst other variables were captured and analysed using IBM SPSS version 23.

RESULTS: The data for 69 (88.5%) out of the 78 patients who had myomectomy was available for analysis. The mean age of patients was 33.3 ± 4.7 years; about 2/3 (65.5%) of the patients were ≤30 years. The pregnancy rate after myomectomy was 55.1% (38/69), most (44.9%) of the pregnancies occurred in the 1st year after myomectomy and about half (46.4%) of the patients were delivered by caesarean section. Patient’s age, shorter duration of infertility and fewer fibroid masses were significantly associated with favourable fertility outcomes (P < 0.001, P < 0.001 and P < 0.05, respectively). Age ≤30 years was most predictive of pregnancy after myomectomy, P < 0.017.

CONCLUSION: The study showed that women with uterine fibroid and unexplained causes of infertility at age ≤30 years have good fertility and obstetric outcome after open abdominal myomectomy.