AUTHOR=Mercorio Antonio , Della Corte Luigi , Boccia Dominga , Palumbo Mario , Reppuccia Sabrina , Buonfantino Cira , Cuomo Lara , Borgo Maria , Zitiello Antonio , De Angelis Maria Chiara , Laganà Antonio Simone , Bifulco Giuseppe , Giampaolino Pierluigi TITLE=Myomectomy in infertile women: More harm than good? JOURNAL=Frontiers in Surgery VOLUME=Volume 10 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1151901 DOI=10.3389/fsurg.2023.1151901 ISSN=2296-875X ABSTRACT=

Adhesion formation following gynecological surgery remains a challenge. The adoption of minimally invasive surgical approaches, such as conventional or robotic-assisted laparoscopy combined with meticulous microsurgical principles and the application of adhesion–reducing substances, is able to reduce the risk of de novo adhesion formation but do not eliminate it entirely. Myomectomy is the most adhesiogenic surgical procedure and postoperative adhesions can have a significant impact on the ability to conceive. Therefore, when surgery is performed as infertility treatment, attention should be paid to whether the benefits outweigh the risks. Among several factors, the size and the location of fibroids are the most accountable factors in terms of adhesion development and post surgical infertility; therefore, the search for effective strategies against adhesion formation in this setting is of paramount importance. The purpose of this review is to evaluate the incidence and factors of adhesion formation and the best preventive measures current available.