Re: Diagnosed w/Uterine Fibroids-37 years old-TTC #1 -LONG

[Guest guest]

Depending on your situation a reproductive endocrinologist (RE) may

feel that a myomectomy would help improve your fertility. Some of the

factors they consider are (this is based on my research but I'm not a

doctor so take it with a grain of salt):

Size

Position

Type

Quantity

How old you are

How long you have been TTC

Any past history of miscarriage

Hormonal imbalances

Any male factor fertility issues

How regular your menstrual cycles are

Read on for more about each...

Size

Some fibroids will grow rapidly during pregnancy due to the increased

production of hormones, some shrink, some don't change and some grow

so rapidly they outgrow their blood supply and die (a process called

red degeneration which can be quite painful). Doctors can't predict

which fibroids which will grow and size doesn't seem to be a

predictor. From what I've read and heard from my acupuncturist and

naturopath smaller fibroids respond more readily to these types of

treatments, fibroids over 4cm can be harder to treat. Larger fibroids

will also have greater blood supplies and can possibly influence the

ability of the uterus to accept a fertilized egg and nourish a

developing embryo.

Position

Fibroids can be positioned in locations which can actually impair

your fertility by blocking the cervix or fallopian tubes which can

impede the ability of sperm to travel where they need to. This is

fairly rare but something which should be ruled out. Fibroids can

also distort your uterus which may have some impacts on fertility but

I haven't seen anything definitive, just speculation. If your

ultrasounds aren't conclusive as to the position of your fibroid/s

then you should have an HSG (hysterosalpingogram) which is a live

xray using a contrast dye that is injected into the uterus and shows

clearly the interior of the uterus and fallopian tubes. It can be a

little painful, mine triggered some cramping that lasted a couple

days, make sure your doctor knows to have you cough when they insert

the catheter which helps to open the cervix. An HSG can help improve

your fertility for approximately 3 cycles afterwards as well,

something to do with helping improve the functioning of the cilia in

the fallopian tubes they think (so I've read).

Type

Submucosal fibroids, ones that are positioned in such a way as to be

on the interior wall of the uterus (and are more likely to cause

bleeding problems) are believed to cause more problems with

implantation Some studies have also shown that intramural fibroids

also impact fertility but each situation is unique and isn't a

definitive predictor of success.

Quantity

I haven't looked into the affects of multiple fibroids on fertility

(I only have one fibroid) but the more fibroids you have the more

difficult definitive treatment is. You are at a greater risk for

regrowth post myo, trying to remove multiple/many fibroids can

compromise the strength of the uterus, and in rare situations the

remaining healthy tissue isn't enough to be able to accommodate the

growth required to sustain a pregnancy. I'm not familiar with any

specific cases where this has happened but it is a possibility.

How old you are

On average, women's fertility begins to decline at age 35. If you are

over 35 then your RE may feel that more aggressive fertility may be

required to help ensure that you have a good shot at a successful

pregnancy.

How long you have been TTC

On average only 80% of couples who are trying to conceive will get

pregnant the first year of trying. However, if you have had at least

6 months of well-timed intercourse (and you have regular cycles) and

you still haven't gotten pregnant, you should consider seeing a

doctor if you haven't yet.

Any past history of miscarriage

If you have had miscarriages before that could be an indicator of

your fibroid interfering with your fertility.

Hormonal imbalances

If your hormones are out of balance then your fertility may be

compromised from the start. Hormonal imbalances that are contributing

to fibroid growth can also impact your fertility. Depending on the

type of imbalance the treatments might impact your fibroid.

Any male factor fertility issues

Fibroids might not be the only issue potentially impacting your

fertility. 40% of fertility problems are with the woman, 40% with the

man, and 20% are combined or unexplained. It is imperative that you

should make sure that your male partner has been tested as well so

that your treatment is appropriate for your fertility situation as a

couple.

How regular your menstrual cycles are

If you don't have regular cycles then this indicates that hormonally

your body isn't in harmony. There are lots of different reasons for

this including diet, lifestyle, how fat or thin you are, stress, past

use of birth control pills, etc. If you don't get your period then

the RE might want to be more aggressive in treatment or may ask you

to make some dietary and lifestyle changes.

Removing the fibroid can help improve fertility rates some in some

situations although further studies are needed. Removing the fibroid

when fertility treatment is needed can help provide a clean palette

in which to work – no fibroids to compromise the pregnancy or grow

out of control when you are treated with gonadotropins.

Your doctor can help with some of the basic diagnostics but before

you try any fertility drugs well and I personally would consult with

an RE for this treatment since they have more advanced training in

this area; your financial situation and health insurance might

dictate otherwise so do what you need to do. Keep in mind that

fertility drugs can cause fibroid growth and can also hyperstimulate

your ovaries so you should be having regular ultrasounds during your

treatment (something general practitioners are usually not equipped

to do).

Fertility treatments are expensive, most health insurance won't cover

treatments except for some diagnostics, and depending on your moral

and philosophical beliefs might not be something you want to pursue.

The fertility clinic you consult with also might be aggressive in

wanting to maintain high statistical successes and this may influence

their recommendations. You should always feel comfortable with any

treatment you will undergo and I recommend always doing your own

research to make sure you understand your options. Also keep in mind

that there are other options for having children such as adoption and

surrogacy should all else fail.

Let me know if you want more information. I can provide links to

articles, books and resources for most of what I've presented here.

And any LOL that would like to add in more about your experiences (or

correct me if you think I've gotten it wrong) please do.

--Ann

> I saw a specialist and how come some of these specialists

> immediately recommend myomectomy??? My specialist recommended BBD

> more...that's it!! What's a newlywed to do

to do??

[Guest guest]

This was wel done Ann, i have saved this in my favourites.

Thx for the reading

donovann70 donovann@...> wrote:

Depending on your situation a reproductive endocrinologist (RE) may

feel that a myomectomy would help improve your fertility. Some of the

factors they consider are (this is based on my research but I'm not a

doctor so take it with a grain of salt):

Size

Position

Type

Quantity

How old you are

How long you have been TTC

Any past history of miscarriage

Hormonal imbalances

Any male factor fertility issues

How regular your menstrual cycles are

Read on for more about each...