Are Fibroids a Concern for Your Pregnancy?

Are fibroids a concern for your pregnancy? In this video, Mark P. Trolice, M.D., board-certified reproductive endocrinology and infertility specialist and founder of Fertility CARE: The IVF Center shares his insights on when you should be concerned about fibroids and what treatments are available to remove them.

“Patients get nervous when I talk about fibroids because fibroids are actually tumors,” says Dr. Trolice.” But fibroids are simply benign (non-cancerous) overgrowths inside the muscle of the uterus. That’s where they start.”

“Fibroids used to be called uterine myomas; they start with one cell, and then they grow. In their reproductive years, about 37% of women will be diagnosed with fibroids. They are more common in African-American women, but the presence of fibroids can increase as a woman moves through her reproductive years.:”

“What’s the big deal with fibroids?” Dr. Trolice asks. “Well, there are gynecologic and reproductive problems with fibroids. Fibroids can also be completely asymptomatic - you may not even know you have them unless we do an ultrasound. But symptomatic fibroids can cause abnormal uterine bleeding, in extreme cases requiring a transfusion. They can cause significant abdominal bloating, pressure on the bladder, and pain. Removing a fibroid, called a myomectomy, is often the treatment.”

Dr. Trolice explains that regarding reproduction, fibroids have been a controversial area in medical literature because for years doctors thought fibroids were definitively associated with infertility. But then researchers started looking at the location and size of the fibroids. When fibroids are inside the uterine cavity or pushing against or distorting the uterine cavity - those are the ones doctors are confident about that reduce implantation and increase miscarriage.

“For years we thought any fibroid in the muscle, even if the cavity was normal and the fibroid was more than 4-5 cm, would cause a problem,” says Dr. Trolice. “But that doesn’t seem to be the case. The only fibroids we promote removing are the ones that are inside the uterine cavity, called submucous fibroids, or those in the muscles of the uterine cavity called intramural, that push on and distort the cavity.”

Why are fibroids a problem?

“It’s not only a question of getting pregnant, but it’s also a question of the health of the pregnancy because miscarriage rates are higher,” says Dr. Trolice. “Also preterm labor and delivery are at a higher rate. The fibroids occupy space in the uterus, and there is only so much space the uterus can grow. Therefore, the presence of fibroids can trick the brain into thinking that it’s full term and increases the risk of going into preterm labor. A fibroid, at term, can also cause a separation of the placenta from the wall of the uterus, called an abruption, which can cause increased bleeding at the time of delivery.”

How are fibroids removed?

“If we need to remove fibroids we do it with the use of a hysteroscope,” says Dr. Trolice. “It’s a simple, one-day outpatient surgery where we put a telescope through the cervix into the uterine cavity and remove the fibroid. You’re home the same day with a swift recovery. The other types of fibroids involve going through the stomach with a laparoscope or robotically with multiple incisions, in rare cases, open incision to carve out and remove the fibroid.”

“There is always a weakening of the muscle of the uterus whenever you invade it to remove a fibroid,” Dr. Trolice continues. “The least invasive way is when the fibroid is inside the cavity. Certainly, the more invasive approach is when you need to go through the outside of the uterus, which can increase the risk of uterine rupture at the time of delivery, so often a cesarean section is recommended.”

“Fibroids are a problem that we see and want to address as part of the evaluation. We want to give you the proper information so you can make an informed decision about which direction to go. The bottom line is that not all fibroids are symptomatic or impair your fertility, but certainly, when the uterine cavity is impacted, surgery is recommended and up to three months of uterine healing before pursuing pregnancy. Hopefully, you can conceive naturally or through the treatment that we offer.”

For more visit https://www.myfertilitycare.com/
To learn more about Dr. Trolice visit http://www.myfertilitycare.com/mark-trolice-md/
To learn more about Fertility CARE fertility services visit https://www.myfertilitycare.com/our-services/
To learn more about IVF visit https://www.myfertilitycare.com/ivf/
To learn more about IUI visit https://www.myfertilitycare.com/infertility-treatment-options/

Видео Are Fibroids a Concern for Your Pregnancy? канала Mark Trolice