What are the chances of pregnancy if the patient has uterine fibroid?

Question

Hello doctor,

I am in my 44th year. I have three grown children, and I am newly married. My husband and I are trying to get pregnant. I have a uterine fibroid; My doctor told me about the risks involved, but she says pregnancy is still possible. I had my first HCG injection, which failed. What should be my next step in this process?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

As you had got pregnant three times, you will surely get pregnant again. The risk factors that need to be eliminated are as follows:

1. Age is the biggest risk. The best age to get pregnant is between 19 and 35 years old. A lady is born with a fixed amount of eggs in her ovary, which she keeps expelling every month. In the race to ovulate, the healthiest eggs are thrown out first, so by age 40, most eggs left are not fully healthy. I do not mean any good eggs. I only say the number of good eggs is low. So this will reduce your fertility potential. But do not lose hope; the oldest lady to get pregnant is 45 years old. To know how many eggs you have, you can have serum FSH (follicle stimulating hormone) on the third or fourth day of your period, and this value should be less than seven miu/ml (milli-international units per milliliter).

Also, you can check the serum AMH (anti-müllerian hormone)level; a normal level is 1.5 to 4 ng/ml (nanogram per milliliter); if the level is less than 1.5 ng/ml, then the number of eggs left in the ovary is low and the chances of pregnancy are poor. This is only a quantitative assessment, not a qualitative one.

2. Fibroids less than 1.9 inches and those not distorting the uterine cavity are okay. Only those bigger ones need to be removed, especially if the location of the fibroid is close to the point of implantation.

3. Before you try for pregnancy, it is advisable to have the fallopian tube evaluated once steps 1 and 2 are normal. Sperm meets the egg in the tube to form an embryo; this travels in the tube for three to four days, and then the embryo enters the uterus. The size of this tube is 1 mm (millimeter); this is a bridge between the uterus and ovary, which cannot be seen on a scan. So you will have to confirm the patency of the tube by HSG (Hysterosalpingography)( imaging with an X-ray), SSG (Sonosalpingography) (imaging with a scan), or laparoscopy.

4. Last but not least, the husband's semen analysis has to be done before the next stimulation. Sperm count, motility, and morphology have to be confirmed.

I hope I have clarified your query.

Do write back if there are any more queries.

Regards.