Did you know that 30% of all women have fibroids by the time they’re 30? While fibroids are incredibly common, for some women, they can be a cause of infertility, especially when their location affects the uterus. We asked Dr. Charles E. Miller to help us better understand how fibroids affect fertility and the recommended treatment options.
Why Fibroid Location Matters
The problem lies in where the fibroids are located. Fibroids in the uterine cavity or near the cavity are particularly concerning when it comes to fertility.
In the past, we always recommended surgery for women with fibroids in the cavity. But over the years, we’ve learned that fibroids near the cavity can be just as problematic.
Back in the 1990s, I conducted a study on women who were either miscarrying or unable to get pregnant and had fibroids within 4mm of the endometrial cavity. After surgery, 70% of them went on to have a successful delivery.
Treatment Options for Fibroids
Surgery remains the primary mode of treatment for fibroids that need to be removed. The approach depends on the size and location of the fibroid:
- If the fibroid is in the cavity or small and close to the cavity, we typically remove it using a procedure called hysteroscopy. This involves placing a small telescope into the uterus and removing the fibroid without any incisions.
- When the fibroid is firmly in the muscle wall or is larger, it needs to be removed laparoscopically. At our practice, we take great pride in performing these procedures minimally invasively.
Unfortunately, at other places, fibroids are sometimes removed via a mini laparotomy, a small but still open incision, similar to a C-section cut. My concern with this method is that it increases the risk of scar tissue, which can further impact fertility.
The Bottom Line
If you’re having trouble achieving a successful pregnancy and you have fibroids, don’t wait. Seek out a specialist with the expertise to evaluate and treat those fibroids properly.
I absolutely recommend a hysteroscopic or laparoscopic approach whenever possible. It’s effective, minimally invasive and gives women the best chance at a healthy pregnancy.