Fibroids

[trumpcard]

I wrote at length about our continuing journey in the August infertility one thread but wanted to have a separate post about my fibroids. I'm hoping to get some more answers this way . . .

My HSG today confirmed that my tubes are open but that I have a fibroid that is in the uterine cavity. RE wants me to see another specialist about having it removed. Anyone out there with any experience with this? The RE thinks that the fibroid could be preventing implantation--similar to an IUD. What can I expect with fibroid removal? What was the procedure and how long the recovery? The RE hinted that we would need to wait to try for a pregnancy for several months following the procedure.

[newmommy27]

I had a fibroid (that my doc thinks was caused by my iud) removed last october

essentially my doc said that he was only removing it b/c I was symptomatic (I had cramping while nursing...and my wee one was only 7 months old then) and b/c I plan to have more children

he described strong ties between infertility and fibroids (very much like and IUD) and he said he had patients who conceived the month after a fibroid was removed

sending much baby dust

[trumpcard]

That's encouraging news. Thanks!

How was the removal? Just an out-patient type of procedure?

[ChristyMarie]

I went with my mom when she had a large fibroid removed. It was outpatient and fairly simple. She took it easy that day but I remember her being pretty much back to normal the next day. HTH.

[newmommy27]

removal took about 20 min (my doc who we know well offered to do it in office assuming it was small)

it turned out not to be small as we had an in office procedure to check it's size...I will never do this again..I was well medicated but it was painful and it turns out I needed a general anyway

recovery was 2 or 3 days...I am sure it would have been easier if I was not nursing a baby around the clock as nursing increased the bleeding...I have the surgery on a friday and was fine to care for my 2 kids on monday

[trumpcard]

I appreciate the input. I will be getting my initial consult tomorrow and hope to get the ball rolling quickly on a surgery. What are thoughts on waiting after the surgery for a couple months before TTC again? With DHs sperm count it's not likely we'd be successful anyway until his issues are addressed but I still hate to wait.

[newmommy27]

my doc did not say not to prevent conception at all

I would say go for it as long as you feel well enough

[trumpcard]

Had my initial consult and I am more confused and upset than ever. The doctor wants to do a laparoscopic removal. That doesn't scare me in itself although I was a little shocked to have him tell me I should plan to be out of work for 1-2 weeks!

The most upsetting part was that he told me that if I have the surgery I will have to deliver any children via C-section. I questioned him on this but he claims that it is not like trying to have a VBAC. According to him, because the procedure is performed when the uterus isn't stretched with pregnancy the risk is even greater of uterine rupture when pregnancy is finally achieved. Something about where the incision has to be made in the uterus . . .

This feels like a deal breaker to me. We are still dealing with MFI and I am tempted to focus our attention on that and not have the fibroid surgery. I put in a call to our RE but it was late this afternoon and he was already gone for the weekend. I am not sure if RE will allow IUI without doing the fibroid removal--not that we are even eligible for IUI until he get DH's sperm count up.

I’m devastated.

[Qbear'smama]

Hi trumpcard,
I am over here from TTC looking for info about fibroids and I wanted to give you a I can't imagine what you are going through but I wanted to say how sorry I am that you are going through this. Fibroids are causing me difficulties, too and I'm trying to figure out what to do. My thoughts are with you.

[slylives]

I've just had an initial consult about fibroid removal, too. I have what appears to be a cluster of small ones, within the edometrial cavity. (I have had two recent losses so they are giving me progesterone in order to facilitate a heavy period, just in case the growths are in fact remnants of the last pregnancy. If they are still there after the next period, it is likely they are fibroids.)

In my case, it looks as though I am unlikely to conceive unless the fibroids are removed. My surgeon is one of the best in MN - I may get another opinion if after the hysteroscopy he recommends surgery, but I will follow his advice.

We spoke about the possibility of a C-section. My doctor was quite blunt, saying that it was unlikely that I would have a successful pregnancy anyway, if they weren't removed. But the key is this: location and size. If the fibroid is located in a place where they have to make a deep cut in the uterine muscle, the chances of C-section are very high. If not, there is no greater risk of C-section than any other pregnancy.

According to my doctor, the growths that appear to be fibroids are not of a size, or in a location, that suggests a risk of C-section. But if they were, I woud have no hesitation in having them removed. When these were first identified by the ultrasound tech, and he was honest in saying that he thought they would definitely have to "come out" for me to have a successful pregnancy, I too was very upset. The thought of a C-section was dreadful to me. But the thought of no more children is even worse.

I am sorry that you are also going through this. Get a second opinion before you proceed with anything. God bless.

[Suka]

I had 3 uterine fibroids(largest was the size of a baseball) removed in dec 08 with the da vinci procedure. So they didnt have to do a bikini cut...I was told that my chances are higher to have a c-section but he had patients who had natural births after the procedure. I think it just depends on where your fibroids are located. I only have 3 small (quarter size)incisions on my tummy. I first did a laproscopic(sp) where they went in threw my belly button and if they were small enough he would have taken them out then, but unfortunately they were not. i have been ttc for 2 iui cycles, 1 home insemination and just recently i DTD with a close friend of mine *crossing fingers*...For the da vinci procedure I was off of work for 2 weeks...Good luck with everything and make sure to get a second opinion...Oh if you dont get the da vinci procedure expect to off work for at least 4-6 weeks...

[MISSNENE]

YOUR STORY GAVE ME HOPE AGAIN...

[LisaG]

Not to burst any bubbles.......

I had approximately 4-5 fibroids removed in 2003 I believe.  There are a few different types of fibroids - some are on the outside of the uterus, some are on a stalk, some are within the actual muscle layer of the uterus, some are in the uterine cavity.  Their location and size factor in to how much of a impact they have on fertility.  I'd suggest gathering as much information as you can, so that you have a better sense of what you're dealing with.

In my case, mine were not in the uterine cavity but they were large and did not respond to a variety of alternative treatments that I did to try and shrink them (fortunately I was asymptomatic for the most part).  I opted to have them removed before ttc (I was also diagnosed with a uterine birth defect and opted to have both taken care of at the same time).  Some fibroids can be removed laproscopically.  When I was researching this (and I don't know how much has changed since then) there was some concern that not all of the fibroid could be removed via lap (due to field of vision and time constraints) and that you were better off doing a myomectomy (abdominal incision similar to a c-section).

There is also (or there was when I was researching) a wide variety of experience among docs doing fibroid surgery.  Some have no business doing it.  I consulted with a supposed "expert" at Cleveland Clinic (she was an RE) and she told me it was the "bloodiest surgery", even bloodier than a hysterectomy.  I then asked her how many she did a year and it was something like 5.  I ended up traveling from Ohio to Philadelphia to work with a surgeon there who promised me I would leave surgery with my uterus still in.  He had people traveling to see him from all over the country and did something like 5 myomectomies per day.

I'm not at all familiar with the Da Vinci procedure mentioned so can't speak to that.  I do know that the reason they may recommend a c-section post fibroid surgery is because a fibroid that was deep in the wall of the uterus can (supposedly) compromise the integrity/strength of the uterus.  Also, I think there's some "rule" that if you've had your uterus cut through (other than lower transverse) you risk out of a vaginal birth due to risk of rupture.

I was told I'd need to have a c-section but I believe that had more to do with the process of having my uterus reconstructed vs. the fibroid removal.  It was really hard for me to come to terms with that and really hard to let go of my dream of a home birth.  Really hard.  And then the journey to having my daughter was so much longer and such a windy, heart breaking road that I got to the point where I was able to make relative peace with the c-section.  Until she had lung problems after arriving and had to be in the NICU for a week.  Although it's hard to say how much of that was due to the fact that even though she was delivered a 38 weeks (scheduled c-section to avoid labor & risk of rupture), she wasn't ready or how much of it was due to not getting to travel the birth canal & have that help with pushing the fluid out of her lungs and/or the combination of factors.  The docs never could decide exactly what was going on other than that she was working quite hard in the beginning to breath.

I truly don't want to take away anyone's hope and I believe its really important to be fully informed.  When I was doing my research there was a fabulous group on Yahoo Groups specifically for fibroids.  It was sooo extremely helpful.

Best of luck to anyone dealing with this.

[prairie girl]

Since this is the Fibroids thread with the most recent post, I though I'd add my story.

I didn't know I had Fibroids until my first miscarriage. Fibroids turned out to the factor in my 3.5 years dealing with recurrent miscarriage & infertility. For a long time I was told "fibroids aren't _usually_ a problem", so we kept TTCing. 

Eventually, I got with a specialist who did 2 surgeries - one hysteroscopic and one laparoscopic to remove them. Four cycles after the last surgery's recovery period I got a BFP and am now 15 weeks pregnant.

So, if you're encounter doctors saying they "shouldn't be" the problem, it's worth exploring further whether they "could be" the problem.

[pitchounette]

prairie girl,  Thank you for your story!  I was just diagnosed with "potential" submucosal fibroids on the endometrium.  I will know more when I have a procedure done by my fertility specialist to actually go in with a camera and look at the condition of my uterus.  The fibroids were initially diagnosed after my HSG procedure noted "multiple filling defects" on the endometrium.  So they may be fibroids, they may be polyps, they may be shadows! 

My concern, obviously, is that the fibroids will be too numerous or won't cooperate with surgery.  HOWEVER, my doctor was very reassuring.  He said fibroids are extremely common and a likely cause of infertility in many women.  Also, if fibroids are removed successfully, our chances of conceiving increase dramatically.  I have a blocked tube (probably due to the fibroids) but otherwise no homornal issues, ovulate regularly, and DH has great swimmers. 

It was a relief to get answers, but also very nerve-wracking to discover this condition. I  have ZERO symptoms of endometriosis or any other disorder.  It's all very strange.  But I'm trying to stay hopeful and it's good to hear stories like yours of successful fiborid removal and eventual BFP.  Yay!!

[prairie girl]

Hi Pitchounette,

Glad to hear your Doctor recognizes the fibroids can cause infertility issues. My fibroids were diagnosed by u/s at my 1st m/c. My specialist had thought I'd need 3 surgeries to remove them, but was able to get it all done in 2.

I am waiting to learn at an appointment at the end of the month whether the surgeries or re-emerged fibroids means I'm more likely to need a c-section or whether this pregnancy is considered high risk b/c of the fibroids or surgery.

Good luck to you. Once you get to the point of surgery, I'd be glad to share my experiences so you have a better idea what to expect in terms of the surgery & recovery.

Prairie Girl