I have fibroids. Could they affect my fertility?

To evaluate prospectively the reproductive performance following hysteroscopic myomectomy in women with submucous fibroids and wishing a pregnancy.

Study Design:

Twenty-nine consecutive women wishing a pregnancy with a previously diagnosed submucous fibroid as a sole cause for reproductive failure were treated by hysteroscopic myomectomy. Fourteen women suffered from primary infertility and 15 women had previous pregnancies with a poor obstetric outcome. The myomas were intracavitary (n = 25) and intramural class 1 (n = 4). None of the patients had type 2 or multiple submucousal fibroids. Myoma size was not larger than 5 cm (the mean was 13.3 mm). Before myomectomy, the outcome reproductive data were recorded prospectively. Following myomectomy, the cumulative rate of first pregnancies, live birth rate and the hysteroscopic anatomical results were assessed and compared with that before surgery.

Results:

The mean duration of follow-up before and after myomectomy was comparable. Twenty-one women (72.4%) experienced 30 pregnancies after myomectomy. Thirteen women gave birth to 16 live infants. Compared with previous pregnancies, the rate of deliveries increased from 3.8% to 63.2% and the abortion rate decreased from 61.6% to 26.3%. No complications occurred during myomectomy. The hysteroscopic anatomical results were good in the majority of cases.

Conclusions:

This prospective study demonstrates that hysteroscopic myomectomy at present is the method of choice to improve the cumulative pregnancy rate as well as the live birth rate in selected women with submucous myomas and a history of reproductive failure.

Please click on the required question.

• 1 What is infertility?
• 2 How prevalent are infertility problems?
• 3 What are the main causes of infertility?
• 4 What are the objectives of our infertility investigations?
• 5 Have there been any noticeable changes in fertility requirements in recent years?
• 6  What is the effect of our age on fertility?
• 7 I smoke cigarettes. Can this have an effect on my fertility?
• 8 Does my weight influence fertility?
• 8A Obesity! How can I lose weight?
• 9 I have fibroids. Could these reduce my fertility?
• 10 I have been told that my womb has an abnormal shape and that was the way that I was born. Could this reduce my fertility?
• 11 I have endometriosis. Could this reduce my fertility?
• 12 I have been told that I have cervicitis or a cervical ectopy (erosion). Could this impair my fertility?
• 13 My doctor tells me that my womb is retroverted (tilts backwards). Could this reduce my fertility?
• 14 I have had an ectopic pregnancy. Does this affect my future fertility?
• 15  We are worried that we may have a fertility problem. What should we do?
• 16 How will our doctor be able to identify the cause of our infertility?
• 17 How can we tell if I am releasing my eggs (ovulating)?
• 18 Investigations have shown that I have a problem releasing my eggs (anovulation). What could be the cause of this?
• 19 How important are my Fallopian tubes in fertility?
• 20 How can we tell if my Fallopian tubes are functioning?
• 21a What are the causes of male factor infertility?
• 21 How can we assess male fertility?
• 22  What is the purpose of a post-coital test (PCT)?
• 23 We have had our infertility investigations and our problem remains unexplained. How can this be?
• 24 What are our chances of achieving a pregnancy?
• 25 Where can I obtain more information?
• 26 Could we have some recommended infertility support groups?
  

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.