Reproductive performance was evaluated after conservative surgery for uterine adenomyoma in a prospective, observational study. Twenty-eight women with histologically proven adenomyomas had conservative surgery in the period 1985-1990. Eighteen patients wanting children were regularly followed for a mean +/- SD period of 53.2 +/- 23.5 months. Crude and cumulative pregnancy rates were calculated after the operation. Thirteen (72.2%) women conceived, for a total of 18 pregnancies: nine (50%) ended in term deliveries, seven (38.8%) in spontaneous abortions, one (5.6%) in ectopic pregnancy and one (5.6%) in a pre-term delivery with neonatal death. The cumulative pregnancy rate at 36 months of follow-up was 74.7%. This analysis of a small series indicates that conservative surgery for adenomyomas is associated with a good reproductive prognosis.