infertility/fibroids

[Guest guest]

Tina wrote:

What other operation has this fertility

success rate when it comes to fibroids?

from

Okay. I'm confused. If you're and not Tina, then

who is Tina? It's so hard to remember everyone -- but even harder

with this kind of confusion!!!! did I miss an email where

this was explained?

Considering that myomectomy has been around at least a good 100 years,

of course there are thousands of pregnancies after this procedure known.

Also, considering there really isn't any other "operation" besides myomectomy

for fibroids when one desires fertility, it would indeed be the only operation

with any kind of success rate. However, sometimes I think a full

fertility work-up is bypassed entirely in lieu of a myomectomy and other

times women undergo myomectomy when they might have been able to conceive

and carry a pregnancy to term even with the presence of their fibroids.

Having fibroids does not necessarily mean they are the source of infertility

nor does it mean that having them removed will definitely increase your

chances of becoming pregnant. I don't know of any controlled studies

that have comparatively answered that question. In fact, I believe

that controlled myomectomy studies are just flat out non-existent.

Of course, particularly large fibroids would certainly be most problematic

with a pregnancy and the location of the fibroids can also present problems

-- 2 obvious issues that would probably warrant their removal prior to

becoming pregnant.

For the national guidelines (U.S.) on determining/treating infertility,

you can review this documentation online:

http://www.icsi.org/guide/Infert.pdf (this is a 47 page

Adobe Acrobat file)

A summary of this documentation can be found at:

http://www.guidelines.gov/FRAMESETS/guideline_fs.asp?guideline=001340 & sSearch_string=infertility

Both documents may require much more discussion with a physician to

truly understand the clinical information presented.

Too often, fibroids are removed via myomectomy but a woman is still

unable to conceive due to endocrinological problems that go undiagnosed

and untreated. The same, unfortunately, can be said of UAE patients

trying to conceive post-procedure. If infertility is an issue, seeing

a reproductive endocrinologist may well be in order before making any specific

treatment decision. Although anecdotal, I can tell you that I've

communicated with many women pre and post UAE and pre and post myomectomy

who desired fertility and yet were never tested for any other potential

causes of their infertility beyond fibroids. Hormonal imbalances

that create fibroids, can also present problems with fertility. Taking

out the fibroids or treating them via UAE does not, necessarily, address

the problem of hormonal imbalance. Two friends of mine who thought

myomectomy (for one) and UAE (for the other) would "cure" their infertility

problems were both suprised to learn that it did not. After seeing

reproductive endocrinologists, both learned their bodies weren't producing

progesterone. With proper treatment and assistance from a knowledgeable

infertility specialist, both conceived and delivered beautiful babies.

There are a lot of variables that play into infertility. Fibroids

is only one. I miscarried one child but carried two others to term

while simultaneously growing some lovely fibroids. "Uncomfortable"

would be an understatement of how I felt at the 9 month mark. Even

so, pregnancy was possible with fibroids -- and is possible for a great

many women. (That said, my first child was "without fibroids" sharing

the womb -- and a much more pleasant and "comfortable" pregnancy, to say

the least. Of course, at the time, I did not know that and complained vociferously

about how uncomfortable I was -- as do all new mothers, I believe!)

Definitely a lot of issues involved with this decision to undergo treatment.

Finding a good fertility specialist that you truly trust would be a major

first step in this process and completely necessary in order to truly understand

your current condition, all of your options, and the potential risks involved

with any given treatment.

Carla