A comparative analysis of spontaneous fertility after myomectomy by laparotomy associated or not with a “second look” laparoscopy

Abstract

Objective: The importance of a “second look” laparoscopy for adhesion formation after myomectomy by laparotomy in improving fertility is not clearly defined in our context. The aim of this study was to compare spontaneous fertility after myomectomy by laparotomy between women who underwent a “second look” laparoscopy and those who did not. Methods: We conducted an analytical cross-sectional study with retrospective data collection from January 1, 2008 to December 31, 2015, comparing spontaneous fertility between patients who underwent “second-look” laparoscopy after myomectomy by laparotomy to those who did not. Firstly, data was collected from the records of patients included in the study. Secondly, through phone calls, informed consent for each participant was obtained after which inquiries were made regarding their fertility status. Results: After a period of 24 months, 23 patients (47.9%) with “second look” laparoscopy conceived, compared to 37 patients (35.2%) without “second look” laparoscopy (p = 0.136); and 24 patients (50.0%) with “second look” had term pregnancies compared to 39 patients (37.1%) without “second look” laparoscopy (p = 0.134). Conclusion: Spontaneous fertility rates seemed to be improved after a “second look” laparoscopy, however, there was no statistically significant difference between spontaneous fertility rates obtained after myomectomy by laparotomy, irrespective of the fact that the patient had undergone a “second look” laparoscopy or not at Yaounde Gyneco-Obstetric and Pediatric Hospital. Keywords: Myomectomy, Laparotomy, Infertility, Adhesions, “Second look” laparoscopy