**7. Take home points**

When we talk about fibroids and infertility, we must take into account the age of the patient and the fibroid number, size and localization.

Type 0,1,2 fibroids can affect implantation and embryo development and hysteroscopic myomectomy may be considered.

Myomectomy should be considered for infertile patients with intramural fibroids that are larger than 4 cm, multiple or that distort the endometrial cavity. Previous failed IVF cycles should be taken into account when making a decision about surgical treatment.

#### *Infertility and Assisted Reproduction*

Cumulative pregnancy rates are similar with laparoscopic and abdominal myomectomy approaches; however laparoscopy is associated with quicker recovery, less pain and less adhesion formation.

Subserosal fibroids do not appear to affect fertility outcome and do not require surgery to improve pregnancy rates.

Clinicians should wait 3 months after surgery prior to IVF, but in older women with low ovarian reserve, embryo cryopreservation and cryopreserved embryo transfer after appropriate uterine scarring should be considered.
