FERTILITY OUTCOMES AFTER CONSERVATIVE MYOMECTOMY: DIAGNOSTIC ASSESSMENT OF POSTOPERATIVE COMPLICATIONS IN WOMEN OF REPRODUCTIVE AGE

This original research was conducted to evaluate fertility-related outcomes and the diagnostic significance of uterine elastography in women of reproductive age with uterine fibroids examined at the Urogynecology and Polyclinic Departments of the Multidisciplinary Clinic of Samarkand State Medical University. A total of 40 women of reproductive age were included in the study: 20 patients underwent conservative myomectomy, 10 patients received medical treatment for uterine fibroids, and 10 healthy women without fibroids served as controls. All participants underwent clinical and anamnestic assessment, gynecological examination, complete blood count, and transvaginal ultrasound combined with uterine elastography. Magnetic resonance imaging was not performed. In patients after myomectomy, special attention was paid to the condition of the postoperative uterine scar, myometrial elasticity, and indirect signs of complications that could affect fertility. According to the diagnostic findings, localized changes in myometrial elasticity in the scar zone were detected in 7 out of 20 patients (35.0%) after conservative myomectomy, while 13 patients (65.0%) demonstrated satisfactory uterine wall elasticity and homogeneous myometrial structure. Minor ultrasound signs of localized fibrosis without clinically significant cavity deformation were observed in 5 patients (25.0%) in the myomectomy group. In the medically treated fibroid group, preserved uterine elasticity parameters were found in 8 out of 10 patients (80.0%), whereas slight focal stiffness associated with fibroid nodes was noted in 2 patients (20.0%). All healthy controls demonstrated homogeneous myometrial elasticity and normal ultrasound findings. During follow-up, regular menstrual cycles and favorable early reproductive indicators were observed in the majority of patients without significant elastographic abnormalities. The obtained results indicate that conservative myomectomy may be associated with localized changes in myometrial elasticity that can potentially influence fertility. Uterine elastography proved to be an informative non-invasive diagnostic method for detecting postoperative uterine alterations and assessing myometrial integrity. Incorporation of uterine elastography into routine postoperative monitoring may improve early diagnosis of complications and support fertility-preserving management in women of reproductive age.

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