TY - JOUR
T1 - Route of myomectomy and fertility
T2 - a prospective cohort study
AU - Wise, Lauren A.
AU - Thomas, Laine
AU - Anderson, Sophia
AU - Baird, Donna D.
AU - Anchan, Raymond M.
AU - Terry, Kathryn L.
AU - Marsh, Erica E.
AU - Wegienka, Ganesa
AU - Nicholson, Wanda Kay
AU - Wallace, Kedra
AU - Bigelow, Robert
AU - Spies, James
AU - Maxwell, George L.
AU - Jacoby, Vanessa
AU - Myers, Evan R.
AU - Stewart, Elizabeth A.
N1 - Funding Information:
L.A.W. reports grants from NIH and AHRQ during the conduct of the study; personal fees from AbbVie, Inc., non-financial support from Swiss Precision Diagnostics, Sandstone diagnostics, FertilityFriend.com, and Kindara outside the submitted work. L.T. has nothing to disclose. S.A. has nothing to disclose. D.D.B. has nothing to disclose. R.M.A. has nothing to disclose. K.L.T. has nothing to disclose. E.E.M. reports grants from NIH/AHRQ, during the conduct of the study; personal fees from Myovant Sciences and Pfizer, outside the submitted work. G.W. has nothing to disclose. W.K.N. has nothing to disclose. K.W. has nothing to disclose. R.B. has nothing to disclose. J.S. has nothing to disclose. G.L.M. has nothing to disclose. V.J. reports grants from Acessa Health, during the conduct of the study. E.R.M. reports grants from AHRQ, during the conduct of the study; personal fees from AbbVie Novo NorDisk, and Moderna; personal fees and non-financial support from Merck, Inc, outside the submitted work. E.A.S. reports grants from AHRQ/PCORI, during the conduct of the study; personal fees from Bayer, AbbVie, UpToDate, Med Learning Group, ObsEva, Peer View, PER, Massachusetts Medical Society, Myovant, outside the submitted work; In addition, Dr. Stewart has a patent Methods and Compounds for Treatment of Abnormal Uterine Bleeding 6440445 issued.
Funding Information:
Supported by grant number P50HS023418 from the Agency for Healthcare Research and Quality (AHRQ), United States with funding provided by the Patient-Centered Outcomes Research Institute (PCORI), United States under MOU number 2013-001. The content of this manuscript is solely the responsibility of the authors and readers should not interpret any statement in this product as an official position or the views of AHRQ, the United States Department of Health and Human Services, or PCORI. L.A.W. reports grants from NIH and AHRQ during the conduct of the study; personal fees from AbbVie, Inc., non-financial support from Swiss Precision Diagnostics, Sandstone diagnostics, FertilityFriend.com, and Kindara outside the submitted work. L.T. has nothing to disclose. S.A. has nothing to disclose. D.D.B. has nothing to disclose. R.M.A. has nothing to disclose. K.L.T. has nothing to disclose. E.E.M. reports grants from NIH/AHRQ, during the conduct of the study; personal fees from Myovant Sciences and Pfizer, outside the submitted work. G.W. has nothing to disclose. W.K.N. has nothing to disclose. K.W. has nothing to disclose. R.B. has nothing to disclose. J.S. has nothing to disclose. G.L.M. has nothing to disclose. V.J. reports grants from Acessa Health, during the conduct of the study. E.R.M. reports grants from AHRQ, during the conduct of the study; personal fees from AbbVie Novo NorDisk, and Moderna; personal fees and non-financial support from Merck, Inc, outside the submitted work. E.A.S. reports grants from AHRQ/PCORI, during the conduct of the study; personal fees from Bayer, AbbVie, UpToDate, Med Learning Group, ObsEva, Peer View, PER, Massachusetts Medical Society, Myovant, outside the submitted work; In addition, Dr. Stewart has a patent Methods and Compounds for Treatment of Abnormal Uterine Bleeding 6440445 issued.
Funding Information:
Supported by grant number P50HS023418 from the Agency for Healthcare Research and Quality (AHRQ), United States with funding provided by the Patient-Centered Outcomes Research Institute (PCORI), United States under MOU number 2013-001. The content of this manuscript is solely the responsibility of the authors and readers should not interpret any statement in this product as an official position or the views of AHRQ, the United States Department of Health and Human Services, or PCORI.
Publisher Copyright:
© 2022
PY - 2022/5
Y1 - 2022/5
N2 - Objective: To assess prospectively the association between the myomectomy route and fertility. Design: Prospective cohort study. Setting: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight clinic centers across the United States. Patient(s): Reproductive-aged women undergoing surgery for symptomatic uterine fibroids. Intervention(s): Not applicable. Main Outcome Measure(s): We used life-table methods to estimate cumulative probabilities and 95% confidence intervals (CI) of pregnancy and live birth by the myomectomy route during 12, 24, and 36 months of follow-up (2015–2019). We also conducted 12-month interval-based analyses that used logistic regression to estimate odds ratios and 95% CIs for associations of interest. In all analyses, we used propensity score weighting to adjust for differences across surgical routes. Result(s): Among 1,095 women who underwent myomectomy (abdominal = 388, hysteroscopic = 273, and laparoscopic = 434), 202 reported pregnancy and 91 reported live birth during 36 months of follow-up. There was little difference in the 12-month probability of pregnancy or live birth by route of myomectomy overall or among women intending pregnancy. In interval-based analyses, adjusted ORs for pregnancy were 1.28 (95% CI, 0.76–2.14) for hysteroscopic myomectomy and 1.19 (95% CI, 0.76–1.85) for laparoscopic myomectomy compared with abdominal myomectomy. Among women intending pregnancy, adjusted ORs were 1.27 (95% CI, 0.72–2.23) for hysteroscopic myomectomy and 1.26 (95% CI, 0.77–2.04) for laparoscopic myomectomy compared with abdominal myomectomy. Associations were slightly stronger but less precise for live birth. Conclusion(s): The probability of conception or live birth did not differ appreciably by the myomectomy route among women observed for 36 months postoperatively. Clinical Trials Registration Number: (NCT02260752, clinicaltrials.gov).
AB - Objective: To assess prospectively the association between the myomectomy route and fertility. Design: Prospective cohort study. Setting: The Comparing Treatments Options for Uterine Fibroids (COMPARE-UF) Study is a multisite national registry of eight clinic centers across the United States. Patient(s): Reproductive-aged women undergoing surgery for symptomatic uterine fibroids. Intervention(s): Not applicable. Main Outcome Measure(s): We used life-table methods to estimate cumulative probabilities and 95% confidence intervals (CI) of pregnancy and live birth by the myomectomy route during 12, 24, and 36 months of follow-up (2015–2019). We also conducted 12-month interval-based analyses that used logistic regression to estimate odds ratios and 95% CIs for associations of interest. In all analyses, we used propensity score weighting to adjust for differences across surgical routes. Result(s): Among 1,095 women who underwent myomectomy (abdominal = 388, hysteroscopic = 273, and laparoscopic = 434), 202 reported pregnancy and 91 reported live birth during 36 months of follow-up. There was little difference in the 12-month probability of pregnancy or live birth by route of myomectomy overall or among women intending pregnancy. In interval-based analyses, adjusted ORs for pregnancy were 1.28 (95% CI, 0.76–2.14) for hysteroscopic myomectomy and 1.19 (95% CI, 0.76–1.85) for laparoscopic myomectomy compared with abdominal myomectomy. Among women intending pregnancy, adjusted ORs were 1.27 (95% CI, 0.72–2.23) for hysteroscopic myomectomy and 1.26 (95% CI, 0.77–2.04) for laparoscopic myomectomy compared with abdominal myomectomy. Associations were slightly stronger but less precise for live birth. Conclusion(s): The probability of conception or live birth did not differ appreciably by the myomectomy route among women observed for 36 months postoperatively. Clinical Trials Registration Number: (NCT02260752, clinicaltrials.gov).
KW - Fibroids
KW - fertility
KW - myomectomy
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85125131358&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125131358&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2022.01.013
DO - 10.1016/j.fertnstert.2022.01.013
M3 - Article
C2 - 35216832
AN - SCOPUS:85125131358
VL - 117
SP - 1083
EP - 1093
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 5
ER -