Exact cause of fibroids is not known & especially the impact on infertility is less evaluated.Ongoing research on fibroids shows high level of aromatase hence hyperestrogenemia.We also noticed that fibroids produce prolactin & hence higher infertility.Ifa first degree female relative has fibroid at <45 years than she has 6 times higher chances of fibroid (31% vs 5%) and if any relative then she has 2.5 times higher chance.Monozygotic Twins have double symptomatic fibroids than dizygotic.Red meat eating women has 3 times higher chances of fibroids then vegetarian & predominantly fish eater have less incidence of fibroid.Per every 10 kg excess weight than normal 18% increase in chance of fibroid.Diastolic rise in BP by 10 mm has 8-0% increased risk.Endothelial injury leads to cytokine release-Fibroid growth.Hypertensive women in later years have 24% more chance of having fibroids and the degree of fibroids was proportionate to this severity of the hypertension.Decrease in incidence by smoking was probably due to associated lower levels of estrogen, 50% reduction in incidence was seen with oral contraceptives, parity leads to 5 fold decreases.In a retrospective study of 3342 cases of uterine fibroids & infertility with or without menorrhagia treated at our institute and outcome after laparoscopic myomectomy especially in infertility~ ART were evaluated with higher pregnancy rate.55% patients had only infertility, 21% patients were lost to follow up, 42% became pregnant, 6% aborted, 31% had normal delivery, Caesarean section was in 69%, patients while no scar rupture was reported.Maximum size of fibroid removed was 18cm;Maximum numbers removed were 17.Conversion to open surgery was in 12 cases, multiple fibroids were present in 60% cases, 52% anterior fibroid 58% posterior fibroids, 6% broad ligament, 24% fundal fibroids & 3% had cervical fibroids.Recurrence Rate after Laparoscopic myomectomy was marginally higher than open surgery.Further in 37% cases of fibroids with infertility no surgery was needed.