Q. What is the treatment for fibroids in my uterine wall?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by Dr. Nithila A
Published on Jun 26, 2019 and last reviewed on: Jul 01, 2019

Hello doctor,

I am 36 years old with 5'8" in height and weight 143 lbs. Started my period when I was 13. My husband and I want to start trying to conceive. We had some tests done to know where we stand since I am not young, and I had a hysteroscopic myomectomy three years ago. Back then my doctor told me I had a couple of other fibroids inside the uterine walls, but his concern was only the one inside the uterine cavity which he removed.

I got two different doctor opinions on my recent tests. Both agree I have two fibroids about 4 cm each inside my uterine wall, that my hormone levels are normal, my husband's sperm looks perfect, and they want to do surgery to remove the fibroids. However, on my HSG test, the lab stated that my right fallopian tube is good, did not mention the left, but on the X-ray, it seems to be blocked. No liquid went through. '

The first doctor was not concerned about the health of my tubes, only the fibroids. The second doctor said the right tube does not look fine, she saw it as distorted upwards and the ovary far away from it, plus one fibroid on each side of it. She thinks the fibroids are to blame for the distortion. My questions are, do fibroids affect the position of the fallopian tubes? Could this be corrected by removing them? Would it make sense to see unblocking options for the left tube? If my fallopian tubes are indeed damaged. Is there any point in having the surgery? Fibroids do not cause me any trouble otherwise.

Dr. R Balakrishnan Menon

Infertility Obstetrics And Gynaecology
#

Hello,

Welcome to icliniq .com.

36 years is not old. Of course, pregnancy chances are higher before 35yrs, but ladies do get pregnant after that too. Fibroids distorting the uterine cavity or tube needs to be removed, also those which are near the implantation site of the embryo, they can cause the inadequate blood supply to the fetus.If fibroids are stretching the tubes thereby blocking the free flow of dye, they need to b removed.

Another option, instead of going for removal is IVF. If fibroids are close to the sides of the uterus, removal may interfere with the blood flow to ovaries, thereby reducing the egg number. Surgery will need cauterization of bleeders, which will reduce the blood flow. So at 36 years, you will not want to reduce eggs number further. If the cavity of the uterus is normal, IVF would be good.Do not worry about the fibroids pulling away tubes from ovaries. Even if you ovulate on the blocker side, the egg will swim or will b pulled to the opposite side. I hope I have clarified your query, do write back if any more questions.

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