It is generally felt that the chances for regrowth decrease significantly if a myomectomy is performed after age 35. A myomectomy is associated with a greater risk of infection as well as a greater blood loss than an average hysterectomy. Fibroids have a rich vascular supply which helps support their growth. As a fibroid is removed, the space which it occupied is obliterated with suturing, yet a small pocket of blood may remain and serve as a potential source of infection. Because of the increased blood loss that occurs during a myomectomy, I always discuss autologous blood donation with my patients undergoing this procedure.
Many women prefer to have banked their own blood in advance as a precaution.
Women who elect a myomectomy are motivated to preserve their uterus and are willing to accept a greater risk to do so. As for the removal of your ovaries at the same time, I think you need to consider your age. At 41, you can expect normal ovarian function for most of the next decade. If your ovaries are removed at the time of hysterectomy, you will experience a sudden fall in your hormone levels and significant menopausal symptoms. It is generally recommended that women consider removal of their ovaries if they are 45 or older at the time of their surgery.