Trying to Conceive with Fibroids

elissia1976

I am 36 years old. My husband and I have been trying to conceive for about nine months now. I have multiple intramural fibroids with the largest around 10 cm. My GYN says they should not interfere with conception unless the Fallopian tubes are blocked. She has suggested removing them though due to increased risk of pain and miscarriage. However, when I've done research on this, there doesn't seem to be strong evidence to support having intramural fibroids removed pre-pregnancy. Has anyone been in a similar situation or have thoughts on this? Thanks!

ksgsmu

I would dump your obgyn and see a good RE.  An RE will most likely want to remove the fibroids.  Fibroids can interfere with implantation depending where they are in your uterus and yes cause miscarraige.  While you may like your obgyn ...they aren't specialized in helping you conceive that is what an RE does. At our age time is important , but it is up to you how aggressive you want to be.   Good luck

elissia1976

Thanks for your input. I actually have been thinking about getting a second opinion or seeing a specialist so good to hear you say that! I don't want to waste too much time given my age.

MarylandWed

My RE suggested removing mine. She ranked our fertility issues as age, h's low motility and fibroid. While my HSG was clear, she said it could be just the 5% help we needed. I had an open myomectomy almost a year ago. It didn't help our fertility but will help with discomfort during pregnancy. I actually didn't realize until afterward how uncomfortable it made me. My urgency to urinate was through the roof. If you do decide to remove them, you will need to decide between laperoscopic and open. My doc had a leading lap surgeon look at my HSG and he determined since I was trying to preserve my fertility that lap was too risky in my case. It wasn't a picnic but I'm glad I did it. GL and let me know if you have any questions.

SD210

Lurker here, and I hope everyone doesn't mind if I chime in.  I'm interested in this conversation because this week I had an ultrasound and discovered that I have fibroids ("too many to count," according to the Radiologist.)  The largest is 10 cm, others are 5-6 cm, with the remaining smaller than that.  This came as no surprise as I had laproscopic surgery to remove 28 fibriods in 2010.  Yes, that is not a typo, it was 28, with the largest being 22 cm long!!!   I had my surgery at Brigham & Women's in Boston, which I highly recommend. 

I knew they would come back, and apparently they are back with a vengeance!  I'm waiting to hear back from my GYN as to whether we need to have the current batch removed before we start to TTC.  (We just got married last month, but I'm 37, he's 36 and we want to start as soon as possible).  I'm assuming that given the number of fibroids, they will want the fibriods removed before we start TTC.  Sigh. I'm not looking forward to another surgery.  

That being said - - I totally agree with @MarylandWed that I didn't realize until AFTER I got them out in 2010 how much they had been bothering me.  It made a huge difference.  

Also, to @Elissia1976, definitely get a second opinion.  My first GYN back in 2010 told me that I need mine removed via open myomectomy and that I would be out of work 6 to 8 weeks.  I got a second opinion from the top lapro GYN guy at Brigham (big women's hospital in Boston), and he took them out laproscopically and I was only out of work 2 weeks.  Of course, it all depends on where they are located and the individual case.  But when in doubt, get the second opinion!

PPL2011

An RE will tell you to get a Myomectomy right away. Any fibroid over 5cm is a problem when coupled with fertility. 

For me it was an open mini-lap surgery with three months of recovery. I removed 4 fibroids and the largest was 6cm. I would goto a reputable surgeon who does lots of myomectomies and I wouldn't put it off.

Your only issue would be that most likely you will not be able to go through a vaginal delivery. It will have to be a c-section. And yes, fibroids grow back...I was told about 2 years.

Good luck! 

elissia1976

Thanks MarylandWed and SD210. @SD210....wow - 28 fibroids removed and now will need another. I'm sorry to hear that. That's one of my concerns because i know they can grow back or new ones develop after. I went for another ultrasound on Tuesday. Tech said ovary looked fine but of course fibroids had gotten bigger. :-( I'll get the "official" results when I go see my GYN in a couple of weeks for my annual. My GYN said she would most likely need to do an open laparotomy to remove them because they are so large and are within the uterine wall. Said recovery time would be 4-6 weeks but I could probably return to work sooner since I work from home and have a desk job. I've been researching fertility specialists in the area and plan to call next week to schedule an appointment. The biggest one I can definitely feel and doc said my uterus is about the size of someone whose 16 weeks pregnant.

elissia1976

Thanks PPL2011. Yeah, she did tell me I would need a c-section if I have the myo. Did you see a surgeon or did your gyno do your myo?

PPL2011

He was a surgeon specialized in minimally invasive gynecological surgery and an ob/gyn. Be brave, it'll be ok!

elissia1976

Thanks!

SD210

It will be OK.  And the recover wasn't that bad (granted, the pain meds help).  I have a desk job and I was back to work in 2 weeks after my surgery.  Good luck!  You will definitely feel better after they are out! 

elissia1976

elissia1976

Called today and scheduled an appt with a RE in my area. Finally settled on one after doing lots of research on the Internet. Receptionist says she's great and that I will love her. Looking forward to the appt to find out what next steps are! From what I've heard she also specializes in robotic surgeries.

elissia1976

Well my husband and I had our first appointment with the RE last week. She's really nice and we felt very comfortable with her. She took our history and talked to us about possible causes of infertility. It worked out that I was on day 2 of my cycle so she went ahead and ordered labs which I had drawn on the spot. Her nurse called the next day with results - I was impressed at the fast turnaround time! Estradiol and LH were normal. FSH, slightly elevated but not outrageously high. She did say my hemoglobin A1c was 6.2 and the normal cutoff is 6.0 so she told me to speak to my PCP about possibly adding Metformin to decrease my risk of diabetes during pregnancy. I'm scheduled for an HSG tomorrow (a little nervous about that). And my husband goes on the 24th for his SA. We meet back with the RE on 11/11 to discuss all of the test results and talk about a plan. She said the fibroids could be causing the fertility issues but there could be other factors as well. And if I do need the surgery to have the fibroids removed, she recommends the open abdominal myomectomy as well due to size (15 cm on u/s last month) and location. Made me feel better that her surgical procedure recommendation was in line with what my regular OB/GYN recommended.