I was told time and time again that my fibroids were not causing issues with fertility. In fact, most research seems to indicate that fibroids do not reduce fertility and that the removal of them does not improve chances of pregnancy. I, however, disagree and so did my reproductive endocrinologist. I found it hard to believe that growths that were described as the size of tennis balls and grapefruits had no effect. I suffered miscarriages and many, many months of not conceiving and I have to think that the fibroids were the problem in at least a few of those months. Studies have even shown that women with fibroids do seem to have lesser implantation rates than those without. So, according to my doctor’s orders, I had a hysteroscopy and eventually a myomectomy prior to my IVF cycle.
Before my visit to the RE, I had sought help from other physicians for extremely heavy, lengthy, and painful periods. Once it was discovered that fibroids were the culprit the primary suggestion was to just “deal with it” unless I wanted a hysterectomy. Looking back, after having the procedures to remove the fibroids and actually having a large fibroid removed at the time of my c-section, that suggestion seems just plain wrong. I “enjoy” much less painful and heavy periods now than I ever did before thanks to the absence of the fibroids. This option should be available to any woman suffering with fibroids – even if she has yet to conceive. It truly does make a world of difference and once you experience a “normal” fibroid free menstrual cycle you learn just how much you have been suffering because of the fibroids.
I, like many of you, had other issues affecting my fertility and would have had to pursue IVF regardless. However, there are safer treatments for fibroids that can preserve fertility and if the effects of the fibroids are threatening your quality of life I think it is well worth seeking treatment for the fibroids in addition to fertility treatments, if necessary. I don’t have the medical expertise to weigh in on whether or not fibroids negatively impact fertility, if they contribute to miscarriage or lack of implantation, or if they should be removed prior to treatment. I do have the personal experience, though, to recommend that if you can find a skilled physician to remove the fibroids in a way that will preserve your fertility then it can be beneficial to your personal health and well-being, if not your ability to conceive.
There are treatments that should absolutely be avoided if you are trying to conceive. Hysterectomy is obviously not an option. But, there are some minimally invasive procedures available now that should also be cautioned against. The time and research is just not there yet to say that they are “safe” for women trying to conceive. Uterine Artery Embolization is highly touted but the long-term effects are not yet known. The procedure cuts off blood supply to fibroids, but can also decrease blood supply to the ovaries causing premature menopause, can affect the uterine lining, and placental function. Myolysis also affects the blood supply to fibroids possibly causing the same fertility destroying problems. Some newer methods of treating fibroids include trying to shrink the fibroids by stopping the production of estrogen or progesterone. With no estrogen pregnancy cannot occur. The progesterone trials, though, are promising but way too new for women to try if they are planning to get pregnant now or in the near future.
Myomectomy – a surgical procedure conducted through the abdomen, hysteroscopy – used for submucosal fibroids, and laparoscopy – best for fewer or smaller fibroids, are considered to be the safest choices for fibroid removal when trying to preserve fertility. Whatever your decision, know that you do have options. This is not a two choice issue – suffer with fibroids until you have children or have a hysterectomy and forego childbearing. Talk to your doctor, and then talk to another one! Second and third opinions are key to finding the best solution for you and your fertility. You will hear a wide array of opinions regarding fibroids and how they do or do not affect fertility. If they are affecting you and your quality of life there is something that can be done – I had them removed, conceived via IVF, more fibroids grew during the pregnancy and were monitored, a c-section was recommended because of the fibroids, and now I have some smaller ones that have not had a negative affect so far. That is just one picture of fibroids and fertility – yours can, and probably will look different, but the important thing to know is that if you aren’t getting the answers you need or want from you doctor you CAN find one that can help.
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