Fibroid Fertility Solutions
Comprehensive management of uterine fibroids to restore fertility and improve reproductive outcomes.
Fibroids and Fertility
Uterine fibroids affect 40-60% of women and can impact fertility through various mechanisms depending on their size, number, and location. Submucosal fibroids have the most significant effect, reducing implantation rates by 50-70%.
Fertility Impact by Type
- Submucosal: 70% reduction in implantation
- Intramural: 30% reduction if >4cm
- Subserosal: Minimal impact unless very large
- Cervical: May obstruct cervical canal
Fertility-Preserving Treatments
Surgical Approaches
Hysteroscopic Myomectomy
- • For submucosal fibroids
- • Outpatient procedure
- • Pregnancy rates: 45-65%
- • Miscarriage reduction: 50-70%
Laparoscopic Myomectomy
- • For intramural/subserosal fibroids
- • Robotic-assisted precision
- • Pregnancy rates: 50-70%
- • Uterine rupture risk: <1%
Non-Surgical Options
Uterine Artery Embolization
- • For women not desiring pregnancy
- • 80-90% symptom improvement
- • Pregnancy possible but higher risk
- • Not recommended for fertility patients
MR-guided Focused Ultrasound
- • Non-invasive thermal ablation
- • Limited fertility data
- • Pregnancy rates: 30-40%
- • Best for small fibroids
Surgical Outcomes & Recommendations
| Fibroid Type | Treatment | Pregnancy Rate | Time to Conception | Recurrence |
|---|---|---|---|---|
| Submucosal | Hysteroscopic resection | 60-70% | 3-6 months | 10-15% |
| Intramural <5cm | Laparoscopic myomectomy | 55-65% | 6-12 months | 15-20% |
| Intramural >5cm | Robotic myomectomy | 45-55% | 12-18 months | 20-30% |
| Multiple fibroids | Combined approach | 40-50% | 12-24 months | 30-40% |
Postoperative Recommendations
- • Wait 3 months before conception after hysteroscopic resection
- • Wait 6-12 months after laparoscopic/robotic myomectomy
- • Consider IVF if multiple large fibroids removed
- • Delivery via C-section if myometrial incision depth >50%
Fibroid Expertise at DAARA
- 3D ultrasound fibroid mapping
- Office hysteroscopy suite
- Robotic surgical precision
- Fertility-sparing myomectomy techniques
- Adhesion prevention protocols
- Combined medical-surgical approaches
- IVF integration planning
- High-risk pregnancy management
Our fibroid fertility program achieves 85% pregnancy rates after treatment with minimal complications. Take the first step toward fibroid-free fertility.
Frequently Asked Questions
Do all fibroids need to be removed before pregnancy?
No. Only fibroids that distort the uterine cavity (submucosal) or are >4-5cm and intramural typically require removal. Small subserosal or intramural fibroids often don't impact fertility. Our detailed ultrasound assessment determines which fibroids need treatment.
Can I have a vaginal delivery after myomectomy?
Yes, if the myometrial incision was superficial (<50% thickness) and healed properly. For deep incisions or multiple fibroid removals, C-section is recommended to prevent uterine rupture. We assess uterine integrity via ultrasound at 34 weeks to guide delivery planning.
How long after myomectomy can I try to conceive?
After hysteroscopic resection: 3 months. After laparoscopic myomectomy: 6 months. After open myomectomy: 12 months. This allows complete healing and reduces rupture risk. We confirm uterine integrity via saline sonogram before clearing for conception.
Do fibroids grow back after removal?
Recurrence rates are 10-30% depending on fibroid number and patient age. New fibroids may develop from microscopic precursors. We recommend trying to conceive soon after recovery and consider fertility preservation if recurrence is likely.
Can medications shrink fibroids for fertility?
GnRH agonists (Lupron) can shrink fibroids 30-50% but cause temporary menopause and aren't suitable for conception. They're used preoperatively to facilitate surgery. Ulipristal acetate shows promise but isn't FDA-approved in the US. Surgery remains the gold standard for fertility patients.