A Cochrane review [Abstract] 1 included 1 trial (131 women) and this was probably underpowered. There was no evidence of a difference in clinical pregnancy rate (OR 0.91, 95% CI 0.44 to 1.90) and live birth rate (OR 0.66, 95% CI 0.31to 1.39) when fibroids were removed via laparotomy or laparoscopy for infertility. Shorter hospital stay, less febrile illness and a smaller drop in pre-operative haemoglobin concentration was noticed with laparoscopy compared to laparotomy. There were no randomised controlled studies comparing hysteroscopic removal or no intervention with other surgical modalities.
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment), by imprecise results (few outcome events), and by potential reporting bias (one small study).
Primary/Secondary Keywords