Received November 23, 2020
Accepted May 31, 2021

Objective: To compare approaches to myomectomy (laparotomic, laparoscopic, robotic). To show the relationship between the number of fibroids and the reproductive diagnosis. Methods: Observational, analytical, retrospective, and cross-sectional study, where the surgical approach used, was evaluated in terms of surgical bleeding, time, number and weight of fibroids and reproductive results. Results: 69 patients were treated through different approaches and divided into 3 groups. The differences found among groups showed in favor of laparotomic myomectomy in terms of the number (p 0.000) and weight of fibroids (p 0.004). A longer surgical time in robotic surgery (p 0.000) was also noticed. In the analysis of the influence on the number of fibroids to achieve pregnancy, the result was in favor of the minimally invasive routes, after surgery, both in the group of < 6 fibroids (p 0.017), and that of > 6 fibroids ( p 0.001), without observing differences in the time from surgery to pregnancy (p 0,979). Conclusion: The surgical approach decision should consider the number and size of resected fibroids, surgical time, and reproductive diagnosis. The minimally invasive route should be offered whenever possible due to its better outcome on achieving pregnancy, without forgetting the benefits of laparotomy, while also accrediting the recently introduced robotic-assisted approach.