Uterine Fibroids & Infertility
Written by: Dr. Mohammed Agdi
The uterus is composed of a thick layer called ‘myometrium’ surrounding a thin lining called ‘endometrium’ into which the embryo implants and which serves to protect and nourish a growing pregnancy. It is the endometrium which is shed each month during the menstruation.
It is very common condition and, approximately, 50% of all reproductive age women will develop benign growths of the myometrium, called fibroid tumors. These tumors are rarely malignant. They can be located in the wall of the uterus, on the outside surface of the uterus or within the uterine cavity.
Most fibroids start as very small lesions and they can grow to large size. Fibroids, even large ones, can occur without producing any symptoms at all. However they can also cause a variety of symptoms depending on their size and location. The most common symptoms are heavy menstrual bleeding accompanied by menstrual pain if fibroid are protruding into the uterine cavity. Some fibroid are large and causing pressure symptoms on the adjacent organs like bladder or colon, pain with deep penetration during sexual intercourse, bladder irritability, rectal pressure, constipation and painful bowel movements.
Most uterine fibroids don’t affect fertility, only those fibroids that protrude into the uterine cavity affect fertility. Exceptions include large intramural fibroids that block the openings of the fallopian tubes into the uterus.
The diagnosis can be made easily by pelvic ultrasound. However, sometimes it is difficult to tell if the fibroid is affecting the uterine cavity. Therefore, many women seeking fertility treatment have to make sure of the integrity of the uterine cavity if ultrasound is equivocal. To ensure normal uterine cavity, a minor procedure called ‘hysteroscopy’ is recommended.
Women who suffer infertility and they have fibroid affecting the uterine cavity are advised for surgical removal of the affecting fibroid. However, there are other kinds of non-surgical treatment which are either not effective or relatively more harmful than surgery.
If you suffer infertility and fibroid, we are as fertility experts the best physicians to consult to discuss informed choices and which surgical intervention works better for your condition.
