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Fibroids and Fertility

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a blog by Genna Banafato, July 17, 2013

Uterine fibroids are a benign time of uterine tumor that is usually completely asymptomatic. The majority of women who have them will never know they are there. However, out of the 20-25% of women who have fibroids, 10% of them will develop some sort of fertility related issue, whether it is difficulty conceiving or miscarriage as a result of the fibroid.

Dr. Allen Morgan of Shore IVF says "the cause of fibroids is unknown, but they all begin as a single cell that begins to replicate itself to grow. So, once this tumor is removed, it will not common back. There is evidence of increased incidence within families. Estrogen has a major influence which stimulates fibroid growth. Fibroids have the potential to enlarge during pregnancy. During the menopause, when there is very little estrogen, the tumors usually shrink." Fibroids can impact getting pregnant if they are blocking the fallopian tubes. Location of the fibroid within the uterus or uterine wall can also lead to miscarriage.

Management and intervention depend on the philosophy of your treating physician as well as future plans for conceiving. Dr. Morgan prefers a patient friendly approach and says treatment can follow one of two courses, "The first, for small or asymptomatic tumors, is a "wait and see" approach including annual ultrasounds to watch for any changes. The second traditional avenue, usually for larger and more symptomatic disease, is a myomectomy for the superficial tumors and a hysterectomy for the more invasive fibroids. Depending on the philosophy of your gynecologist, the ovaries may or may not be removed. My approach is much more patient-friendly with fertility preservation in mind. However, if the patient is not interested in having children, then the above options are available."

Symptoms of fibroids can include: pelvic fullness, increased cramps/flow/clots during your period, irregular or painful periods, increased urinary frequency, constipation or bloating. You can read more about fibroids here.

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