Each month we host a free online seminar where patients can ask the physicians of Fertility Solutions questions about infertility in real-time. The seminar for April focused on ‘Fibroids, Fertility and Pregnancy’. Some of our past topics include Optimizing Natural Fertility, Ask an Embryologist and Preimplantation Genetic Diagnosis. View the live Q & A chat below:
Fibroids, Fertility and Pregnancy
(04/11/2012)
7:02
Fertility Solutions:
Welcome to the Fertility Solutions Live chat on Fibroids Fertility and Pregnancy.
Fibroids are very common benign tumors of the uterus affecting 25% of women of reproductive age. They can cause varied clinical symptoms or may be incidentally discovered during pelvic exam or an ultrasound.
Their management can vary depending on symptoms and reproductive wishes of the patient. Recommendations for management of fibroids in patients planning a pregnancy or patients with infertility can be controversial.
I welcome your questions!
Wednesday April 11, 2012 7:02 Fertility Solutions
7:03
Fertility Solutions:
Location and size of fibroids are the two most important parameters used in making treatment recommendations
Wednesday April 11, 2012 7:03 Fertility Solutions
7:04
Fertility Solutions:
Fibroids located close to the lining of the uterus tend to be most problematic in terms of symptoms and adverse impact on fertility
Wednesday April 11, 2012 7:04 Fertility Solutions
7:06
Fertility Solutions:
One of the reasons why an evaluation of the uterine cavity is recommended during routine infertility testing is to rule out presence of fibroids which impinge on the lining of the uterus.
Wednesday April 11, 2012 7:06 Fertility Solutions
7:10
[Comment From wh15390 wh15390 : ]
Hello! I was wondering if fibroids located on the outside of the uterine cavity cause fertility issues?
Wednesday April 11, 2012 7:10 wh15390
7:10
Fertility Solutions:
Fibroids located on the outside of the uterine cavity are typically not a problem for fertility
Wednesday April 11, 2012 7:10 Fertility Solutions
7:10
[Comment From Emilie Emilie : ]
I had lots of problems with two fibroids during my last pregnancy. I was told they may shrink. It’s now been almost 4 months since I gave birth. I used midwives for my birth and gyno care in the past and won’t be trying to have another baby until the summer of 2013. What if anything should I be doing to manage them at this point?
Wednesday April 11, 2012 7:10 Emilie
7:12
Fertility Solutions:
Fibroids may shrink as after a pregnancy or become calcified. You should have an ultrasound to evaluate them and see if there has been any change in them since your pregnancy
Wednesday April 11, 2012 7:12 Fertility Solutions
7:13
Fertility Solutions:
Calcified fibroids will not typically grow further and are not likely to cause you further problems
Wednesday April 11, 2012 7:13 Fertility Solutions
7:14
Fertility Solutions:
If they do not shrink or grow further you may consider intervention prior to your next pregnancy to avoid recurrence of the problems you experienced
Wednesday April 11, 2012 7:14 Fertility Solutions
7:14
[Comment From wh15390 wh15390 : ]
Is it true that with uterine fibroids that natural birth isn’t possible?
Wednesday April 11, 2012 7:14 wh15390
7:15
Fertility Solutions:
Most fibroids do not impact natural birth. Some may be large or located in the uterus in a place where baby’s passage through the birth canal may be obstructed
Wednesday April 11, 2012 7:15 Fertility Solutions
7:15
[Comment From Emilie Emilie : ]
When should I get the ultrasound?
Wednesday April 11, 2012 7:15 Emilie
7:16
Fertility Solutions:
Emilie, usually we would recommend an ultrasound 6 months after delivery
Wednesday April 11, 2012 7:16 Fertility Solutions
7:18
Fertility Solutions:
Most difficulties with fibroids in pregnancy are related to fibroid growth. They can cause pain and even preterm labor
Wednesday April 11, 2012 7:18 Fertility Solutions
7:18
[Comment From wh15390 wh15390 : ]
if uterine fibroids become bothersome what recommendations do you offer?
Wednesday April 11, 2012 7:18 wh15390
7:20
Fertility Solutions:
Fibroids can be managed with either medication or surgery. There are non-surgical ways to manage them as well such as immobilization or high frequency ultrasound. All of these options are available to patients who are not planning a pregnancy.
Wednesday April 11, 2012 7:20 Fertility Solutions
7:21
Fertility Solutions:
Unfortunately, for those patients trying to maintain or improve their fertility, surgery is typically the only option
Wednesday April 11, 2012 7:21 Fertility Solutions
7:23
Fertility Solutions:
How many of you have had trouble conceiving and were told fibroids were contributing to the problem?
Wednesday April 11, 2012 7:23 Fertility Solutions
7:28
Fertility Solutions:
The simplest way to manage symptoms of fibroids may be a treatment with a birth control pill. It helps to decrease the menstrual bleeding and often decreases pain .
Wednesday April 11, 2012 7:28 Fertility Solutions
7:30
Fertility Solutions:
Do any of you have other questions regarding fibroids
Wednesday April 11, 2012 7:30 Fertility Solutions
7:30
[Comment From wh15390 wh15390 : ]
what are the risks? With surgery?
Wednesday April 11, 2012 7:30 wh15390
7:33
Fertility Solutions:
Surgery can be done using minimally invasive techniques such as hysteroscopy, laparoscopy or robotic surgery. It can also be done using traditional open techniques. Recovery times are generally faster with minimally invasive approaches, but they cannot be used for all patients. Size and location of fibroids are most important in determining surgical approach.
Wednesday April 11, 2012 7:33 Fertility Solutions
7:34
Fertility Solutions:
Risks are always infection (small), bleeding (moderate and dependent on size and number of fibroids). There is also a risk of bleeding which may be severe enough to require a hysterectomy. Luckily that risk is very small
Wednesday April 11, 2012 7:34 Fertility Solutions
7:34
[Comment From wh15390 wh15390 : ]
I was told that I have uterine fibroids but they aren’t the cause of my fertility.
Wednesday April 11, 2012 7:34 wh15390
7:35
Fertility Solutions:
The fibroids located close to the lining are the only ones linked to infertility by multiple studies
Wednesday April 11, 2012 7:35 Fertility Solutions
7:36
Fertility Solutions:
Fibroids in the wall have to be very large to have an adverse impact on fertility. In general, those fibroids which are located close to the outside of the uterus are of no consequence for fertility
Wednesday April 11, 2012 7:36 Fertility Solutions
7:38
Fertility Solutions:
One other risk of surgery that needs to be mentioned is the high probability for scar tissue formation. Scar tissue may affect the fallopian tubes which can have an adverse impact on the ability to conceive
Wednesday April 11, 2012 7:38 Fertility Solutions
7:41
Fertility Solutions:
Thank you for your participation in the Fertility Solutions live chat
Wednesday April 11, 2012 7:41 Fertility Solutions
7:42