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Obstetrics Gynecology Conditions & Treatments - row of books

Uterine Fibroids

What are uterine fibroids?

Uterine fibroids are benign (non-cancerous) tumors comprised of muscle cells derived from the uterus. Fibroids can grow on the surface, middle or cavity of the uterus. They are very common, being found in up to one in four women during the reproductive years. Most uterine fibroids cause no symptoms, although they can cause the uterus to feel enlarged during routine pelvic exams.

Ultrasound and saline infusion hysterosonogram are the most common diagnostic tests utilized to diagnose fibroids. In some circumstances, magnetic resonance imaging (MRI) may be needed to determine the size and location of fibroids.

What are the symptoms of fibroids?

Most women with fibroids have no symptoms at all. Symptoms from fibroids are related to the size, number, and location of a woman’s fibroids. The most common symptoms from fibroids are heavy menstrual bleeding, painful menstrual periods, pelvic pressure, and frequent urination. Less frequently, fibroids can cause partial blockage and damage to one or both kidneys.

How do uterine fibroids affect fertility and pregnancy?

Since fibroids develop in women during their childbearing years, a typical question is, “How do uterine fibroids affect fertility and pregnancy?” While many pregnant women with uterine fibroids experience no adverse effects as a result of uterine fibroids, the following complications are possible:

  • Fallopian tubes may become blocked or compressed, which can cause infertility
  • Fibroids that distort the inside of the uterus can cause infertility due to failure of implantation, and arly pregnancy loss.
  • During the second and third trimesters of pregnancy, during a process called “degeneration”, the blood supply to a uterine fibroid can become compromised causing severe abdominal pains.
  • Fibroids located in the cervix can cause breech presentation or block the head from coming down into the pelvis during labor.
  • Large fibroids can sometimes cause postpartum hemorrhage (excessive bleeding after childbirth).

What are some fibroid treatment options

Because fibroids are benign tumors that regress after the menopause, treatment is not needed if the fibroids do not cause symptoms or injury to adjacent organs. When symptoms are disruptive or if fertility is affected, fibroids can be treated with various methods. An woman with symptomatic fibroids must consider how each specific treatment will help her particular symptoms and how the treatment may affect her fertility and the outcome of future pregnancies. Due to the increased risk of bleeding, uterine fibroids are typically not removed during pregnancy. Options for treatment of fibroids include:

  • medication or hormonal therapy
  • Ulipristal Acetate is a medication that may soon be on the market and could revolutionize fibroid treatment
  • high-intensity focused heat, cold or ultrasound waves
  • endometrial ablation
  • uterine artery embolization which uses small particles to block the blood supply to the fibroids
  • hysterectomy (surgical removal of the uterus)
  • myomectomy (surgical removal of uterine fibroids, recommended for women who are trying to become pregnant)

How can myomectomy fibroid surgery improve fertility?

If you have uterine fibroids that distort the cavity of your uterus, a myomectomy may improve your fertility.  We can work with your infertility specialist to tailor the procedure to your needs.