Fibroids and Fertility

Fibroids which are considered to have a negative impact on fertility include those which are:

• growing in the cavity of the uterus

• growing in the muscle of the uterus but distort the shape of the uterus

• 10 cm or greater

The fibroid which is growing in the cavity of the uterus (submucosal fibroid) is removed during a hysteroscopy. This is a 30 minute procedure performed under general anaesthetic. The fibroid is removed using a device called a Myosure. (see gallery)

The fibroid which is growing into the muscle of the uterus (intramuscular fibroid) is removed as a laparoscopic procedure (laparoscopic myomectomy). The fibroid is “shelled” out of the uterus and removed. The cavity in the uterus is closed using laparoscopic sutures. (see gallery)

If there are multiple intramuscular fibroids, an open approach is used to remove the fibroids. A 10 cm incision is made in the pubic hairline and the fibroids “shelled” out of the uterus. The cavity in the uterus is closed using sutures.

Fibroids can grow back so those women who are planning to become pregnant in the future must try to conceive as early as possible after the myomectomy procedure. However, following surgery to remove a fibroid growing in the muscle of the uterus,Dr Cook will advise you to wait for 3 months until the uterus heals.

The incisions made in the wall of the uterus to remove fibroids may cause placental problems (abnormal implantation of the placenta).

A Caesarean delivery is recommended to avoid uterine rupture during labour.