Sometimes, I'm asked if a myomectomy can improve somebody's fertility. First, let me explain what a myomectomy is. A myomectomy is a procedure in which fibroid tumors, which are smooth benign tumors of the uterus, can be removed. Myomectomies can be done by an open incision, or they can be done using a laparoscope, or they can be done even vaginally, with a special heated loop that goes through the cervix into the uterus and removes the portion of fibroid within the uterine cavity.
In order to know whether myomectomies actually can improve fertility, we have to first ask if myomectomies actually can cause infertility. That data is a little sketchy. There are very good data that suggest that myomas, or uterine fibroids can actually cause recurrent pregnancy loss, but the data about them causing infertility is a lot less.
We're not really sure that they do cause infertility, but we do suppose or suggest that they cause infertility when they either block the Fallopian tubes so that the sperm and eggs can't meet, or in cases in which the uterine cavity is so distorted that implantation can't occur. In those cases, I believe that myomectomy can, in fact, improve fertility.