This video demonstrate Laparoscopic Myomectomy for Intramural Myoma with Submucosal Extension. For fibroids that distort the cavity there is consensus of a negative impact on both the clinical pregnancy rate and delivery rate together with dysfunctional uterine bleeding. Uterine leiomyomas are present in 30-70% of women of reproductive age. In addition to causing menstrual disorders and pain, uterine fibroids negatively affect fertility and pregnancy outcome for patients pursuing assisted reproduction. The two questions that have to be addressed are: which fibroids should be treated, and how they should be treated? Submucosal fibroids are associated with a 70% reduction in delivery rate. Intramural fibroid had a lesser effect and reduced the delivery rate approximately 30%. In contrast, studies on subserosal fibroids did not negatively impact fertility. Furthermore, both submucosal and intramural fibroids were associated with an increased risk of spontaneous miscarriage. Myomectomy is considered the treatment of choice to alleviate these detrimental effects. Further research is needed before alternative treatments can be recommended.