Fibroids and Fertility
While no study has yet been able to pinpoint specific evidence as to why some women with fibroids seem to have a higher than normal risk of miscarriage or trouble conceiving, multiple studies have found there may be an association between fibroids and infertility -- researchers just haven't found what that is yet.
Some research indicates submucosal fibroids -- those are the type that grow in the uterus -- may twist or misshape the uterus, causing conception and pregnancy complications. Other theories suggest that the location of the fibroid(s) may play a role in early miscarriage, and that fibroids growing in the uterus or within the uterine wall may impact blood flow to the placenta and cause an irritable uterus.
Treatment options vary depending upon the age of the patient, the severity of the symptoms and the size of the tumor(s), as well as whether or not the woman wants to try to have children. For many women, over-the-counter pain relievers may be the only thing needed to minimize symptoms. For others, hormone therapy may be the right choice to stop fibroid growth.
Surgical interventions are typically needed for fibroids that cause moderate to severe symptoms. Women with severe symptoms and/or chronic fibroids who have already had children or who aren't interested in having children often undergo a hysterectomy, which removes the uterus and is 100 percent effective in treating fibroids and their symptoms. These women also may consider a procedure called endometrial ablation, which destroys the uterine lining via heat, laser, freezing or microwaves, or uterine fibroid embolization (UFE) or uterine artery embolization (UAE), which block blood flow to the fibroids, causing them to shrink.
Treating fibroids in women who hope to have children some day and wish to preserve their fertility is a little different, and the treatment methods used in such cases are minimally invasive and aimed at preserving the uterus as much as possible.
Currently, a procedure called myomectomy, a minimally invasive surgical removal of fibroids, is used to treat women who still wish to have children. Recent findings show that women who choose to have fibroids removed via a myomectomy risk having new fibroids develop (which happens to about one-third of women who undergo the procedure), but you can't argue with the success rate: It's estimated that as many as 40 to 60 percent of women who have undergone a myomectomy to remove fibroids have gone on to become pregnant post-treatment [source: WebMD, GUH-DVIR].
More Great Links
- Brody, Jane E. "PERSONAL HEALTH; Options for Dealing With Uterine Fibroids." The New York Times. 2009. (June 22, 2012) http://query.nytimes.com/gst/fullpage.html?res=9503EED71E3BF930A25753C1A96F9C8B63
- Cleveland Clinic. "Center for Menstrual Disorders, Fibroids and Hysteroscopic Services." 2009. (June 22, 2012) http://my.clevelandclinic.org/Documents/OB_GYN/fibroid_brochure.pdf
- Georgetown University Hospital. Division of Vascular and Interventional Radiology. "What are Fibroids?" (June 22, 2012) http://www.fibroidoptions.com/backgrnd.htm
- Lee, Hee Joong; Norwitz, Errol R.; and Julia Shaw. "Contemporary Management of Fibroids in Pregnancy." Reviews in Obstetrics & Gynecology. Vol. 3, no. 1. Pages 20-27. 2010. (June 22, 2012) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876319/
- Puscheck, Elizabeth E. "Infertility." 2012. (June 22, 2012) http://emedicine.medscape.com/article/274143-overview#showall
- Stöppler, Melissa Conrad. "Uterine Fibroids (Benign Tumors Of the Uterus)." MedicineNet.com. 2010. (June 22, 2012) http://www.medicinenet.com/uterine_fibroids/article.htm
- U.S. Department of Health & Human Services - Agency for Healthcare Research and Quality. "Management of Uterine Fibroids - Summary: Evidence Report/Technology Assessment: Number 34." 2001. (June 22, 2012) http://www.ahrq.gov/clinic/epcsums/utersumm.htm
- U.S. Department of Health & Human Services - Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "Uterine Fibroids." 2005. (June 22, 2012) http://www.nichd.nih.gov/publications/pubs/upload/uterine_fibroids_2005_rev.pdf
- U.S. Department of Health & Human Services Office on Women's Health. "Uterine fibroids fact sheet." 2008. (June 22, 2012) http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.cfm
- U.S. National Library of Medicine. "Uterine fibroids." 2011. (June 22, 2012) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001912/
- WebMD. "Uterine Fibroids." 2010. (June 22, 2012) http://women.webmd.com/uterine-fibroids/uterine-fibroids