Treating Uterine Fibroids

a blog by Beth Hartog, M.D., East Coast Infertility & IVF, January 26, 2012

Have you been diagnosed with uterine leiomyomas (fibroids)?

Besides causing annoying symptoms such as irregular bleeding and pelvic discomfort, fibroids may interfere with conception and pregnancy. If you are struggling with infertility and you also have been given the diagnosis of fibroids; the following information may help you navigate your treatment.

Uterine fibroids are very common. Fibroids are benign growths of the muscle of the uterus. They can be located in the cavity (submucosal), within the muscle itself (intramural), or on the surface of the uterus (subserosal). Fibroids may be very small (less than 1 cm) or grow very, very large (greater than 20 cm).

The location of your fibroids, much more than the size of your fibroids, predicts whether or not your fibroids are playing a role in infertility. Submucosal fibroids are the likeliest to interfere with conception. They may interfere with an embryo implanting in the uterus because they may be in the way! Intramural fibroids may protrude into the cavity, distorting the shape of the cavity. The fibroids in this location may also prevent establishing a pregnancy. The subserosal fibroids are not very likely to be playing a role in your infertility unless they are very, very large.

Surgical removal is the best way to treat fibroids in women who are trying to conceive. Submucosal fibroids are best removed via hysteroscopic resection, which is when a telescope is placed through the cervix, and the fibroid is shaved away. The intramural and subserosal fibroids can be removed by laparoscopic surgery, which is where a telescope is placed through the belly button to remove them. If the exact location or the size of the fibroids aren’t amenable to these telescopic procedures, an open procedure called an abdominal myomectomy may need to be done.

After surgery for removal of fibroids, you should wait three to six months before you attempt conception to allow the uterus to heal.