Myoma: know when this damage impairs your fertility
One of the main complaints we have at our clinic is the difficulty of becoming pregnant associated with the presence of a fibroid. The reason is simple: because it is common in women over 30 years of age, it is not uncommon to find fibroid nodules in patients with infertility or repeat miscarriages. To get an idea, it is estimated that approximately half the women in the world are fibroids. So, is it that these fibroids are solely responsible for this difficulty in getting pregnant? In a large part of couples, the answer is no.
Firstly, it is important to note that myoma is a benign tumor - that is, it does not turn into cancer - and affects women who are generally between 30 and 50 years of age, being the main responsible for surgeries to remove the uterus. The main symptom of myoma is increased menstrual flow, ie, more intense and longer lasting bleeds than usual.
Although common, uterine fibroid is only responsible for only 3% of all cases of infertility
However, although common, uterine fibroid is only responsible for only 3% of all cases of infertility.
What types of fibroids make it difficult to conceive?
First of all, it is important to understand that the uterus is pear-shaped and has a cavity the endometrium, is where the baby grows.
Another type of myoma that also impairs fertility is the one that is on the wall of the uterus (intramural) and which is called the submucosal, that is, that occupy the inner cavity of the uterus. or distorts it. This happens with bulky fibroids, that is, with diameter above 4 to 5 cm. However, fibroids that grow out of the uterus, called subseroses, do not usually disrupt fertility, with a few rare exceptions.
When is myoma removed?
Surgery is indicated in patients with infertility and fibroids as described above: located in the uterine cavity and / or larger than 4 to 5 cm. Other situations that should also be considered are repetitive miscarriages or major symptoms (enlargement of the abdomen and heavy menstrual bleeding).
Removal of myoma, or myomectomy, can be performed through three types of surgery: laparoscopy, hysteroscopy and laparotomy. The first two are considered minimally invasive and are made through video cameras and delicate tweezers inserted through small holes in the skin or uterus. Thus, they provide a faster recovery and with fewer complications. Laparotomy is the traditional technique, with a larger abdominal incision. The choice of technique depends on the location, number and size of myomas, as well as the training of the physician and his or her team.
An alternative to surgery is embolization of the uterine arteries. Finally, since fibroid is rarely the only cause of infertility, it is also essential that we investigate all other possible factors that make it difficult to pregnancy. Many fibroids are asymptomatic and do not need to be treated. Thus, the evaluation of a specialist is important to define the best approach for the couple.
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