One of the most important questions for women having myomectomy for fertility reasons is: does it actually improve conception chances, and when is it safe to try after surgery? This article covers the evidence and the practical timeline.
Does Myomectomy Improve Fertility?
For submucosal fibroids: yes, clearly. Multiple studies and meta-analyses consistently show that removing submucosal fibroids that distort the uterine cavity improves natural conception rates, IVF success rates, and reduces miscarriage risk. The evidence here is robust enough to support routine myomectomy before fertility treatment for cavity-distorting fibroids.
For intramural fibroids without cavity distortion: less clear. Some studies show improved conception rates after removal, others do not. The decision depends on fibroid size (larger fibroids more likely to be worth removing), number, and the overall fertility picture. See our article on trying to conceive with fibroids.
When Is It Safe To Try After Myomectomy?
The answer depends on the surgical approach and extent of the procedure:
Hysteroscopic myomectomy: Typically 1–3 months after surgery before trying to conceive. The endometrium and cavity need time to heal. Your surgeon will give you a specific timeframe based on what was removed.
Laparoscopic myomectomy: Typically 3–6 months of waiting is recommended. The uterine wall needs to heal and gain tensile strength before pregnancy places mechanical load on it.
Open (laparotomy) myomectomy: Most surgeons recommend 6–12 months before trying to conceive. The uterine incisions need to fully scar and strengthen. Attempting pregnancy too early after open myomectomy carries a risk of uterine rupture — which, while uncommon, is a serious complication.
Maximising the Window After Myomectomy
The postoperative period is an excellent time to establish the lifestyle foundation for hormonal health — while the surgical recovery is complete and before active trying begins. An anti-inflammatory diet, correction of any remaining iron deficiency (see our iron guide), and establishing the natural management protocol creates the best hormonal environment for both conception and reduced recurrence risk after surgery.
Read next If you want to understand the hormonal side of this, how estrogen drives fibroid growth — and what shifts it.