by Dr. Wendy Cutler
Uterine fibroids are the most common benign uterine tumors. Approximately 30-50% of women have uterine fibroids. They are among the most common incidental findings of the female reproductive system. Fibroids can have a significant impact on fertility.
Uterine fibroids are muscle tumors. More than 99% of the time, they are non-cancerous. The real reason why some women form fibroids — but others do not — is not known. There is some evidence that it runs in the family. The location of fibroids is the most important issue. If fibroids grow into the endometrial cavity (where a pregnancy grows) fertility can be affected. Thus, it is recommended to have these kinds of fibroids removed before conception. If fibroids are small and grow within the muscle or on the surface of the uterus, they usually do not cause any issues. Larger fibroids in these locations may affect fertility or cause an increase in physical symptoms.
There are different treatment options for fibroids. Birth control pills may slow down the growth, but this is not an option for women seeking fertility. Lupron is an injection frequently given to women who have fibroids before a surgery to shrink the size of the fibroid(s). This can help to decrease the amount of blood lost during surgery.
The surgery to remove fibroids is called a myomectomy and can be done in a few different ways. A hysteroscopic myomectomy is performed by placing a camera through the vagina and cervix and into the uterus. Alternatively, a surgeon may remove fibroids through the abdomen in a procedure called a laparoscopy or laparotomy. A laparoscopy is a minimally invasive surgery that surgeons perform through tiny little incisions on the abdomen. A laparotomy is a traditional approach in which the surgeon has to make a longer incision on the lower abdomen. However, each patient’s situation is different. It is recommended for a patient to discuss the best treatment option with their physician.
Some women may wonder what to do if uterine fibroids are diagnosed during a pregnancy. This happens often. The good news is most of these fibroids are not in the endometrial cavity. Most pregnant women do well and have good outcomes.