Uterine Fibroids - Treatment Overview
For infertility and pregnancy problems
If you have
fibroids, there is no way of knowing for certain whether they are affecting
your fertility. Fibroids are the cause of infertility in only a small number of women. Many women with fibroids have no trouble getting pregnant.4
If a fibroid distorts the wall of the
uterus, it can prevent a fertilized egg from implanting in the uterus.
This may make an
in vitro fertilization less likely to be successful,
if the fertilized egg doesn't implant after it is transferred to the
Surgical fibroid removal,
myomectomy, is the only fibroid treatment that may
improve your chances of having a baby.4 Because
fibroids can grow again, it is best to try to become pregnant as soon as
possible after a myomectomy.
For severe fibroid symptoms
If you have
fibroid-related pain, heavy bleeding, or a large
fibroid that is pressing on other organs, you can consider shrinking the
fibroid, removing the fibroid (myomectomy), or removing the entire uterus
(hysterectomy). After all treatments except hysterectomy, fibroids may grow
back. Only myomectomy is recommended for women who have childbearing
To shrink a fibroid for a short time, hormone therapy with a
gonadotropin-releasing hormone analogue (GnRH-a) puts
the body in a state like
menopause. This shrinks both the uterus and the
fibroids. Fibroids grow back after GnRH-a therapy has ended. GnRH-a therapy can help to:
- Shrink a fibroid before it is surgically removed. This lowers
your risk of heavy blood loss and scar tissue from the surgery.
- Provide short-term relief as a "bridge therapy" if you are nearing
menopause. (Fibroids naturally shrink after menopause.)
GnRH-a therapy should be used for only a few months,
because it can weaken the bones. It also may cause unpleasant menopausal
To surgically remove fibroids,
myomectomy can often be done through one or more small
laparoscopy or through the vagina (hysteroscopy). Some surgeries can be done using robotic tools. Sometimes, a larger abdominal incision
is needed depending on where the fibroid is located in the uterus.
Myomectomy preserves the uterus,
and it makes pregnancy possible for some women.