PREGNANCY AND FIBROIDS

I am 39 years old. My physician diagnosed me with fibroid tumors the size of a a 41/2 to 5 month pregnancy. I wondering will this prevent me from having children? I was considering having a myomectomy but I am concerned that there will be some scarring and will prevent me from having a baby. I was pregnant once and the pregnancy developed in my tubes. What are my chances of having healthy pregnancy?

A. Austin

Dear drose-
Retained tissue from miscarriages does not cause fibroid tumors. Having had a myomectomy in the past, and now having recurrent tumors, could be the cause of failed implantation of the fetus. In most cases, successful preganancies have occured in the face of having fibroids. Pregnancy can occur with fibroids because the tumors do not interfere with implantation.
However, the size of the tumors, then becomes an obstacle for continued fetal growth which can lead to miscarriages. If you continue to have the desire to have children I would recommend having FAS to remove your tumors. IT seems that you have had two failed pregnancies as a result of the tumors. Please see website section on fibroid tumors.

Dear Austin-
Please refer to the posting for drose. AS you can see, fibroid tumors can cause difficulties with pregnancy.
With the size of your described tumors, this may cause you some problems with a pregnancy. FAS has been successful in the past in removing tumors and preserving ones fertility. The location of the tumors are paramount in this preservation process. Tubal scarring either from blockage secondary to fibroids or from prior tubal pregnancies will effect fertility. After your tubal pregnancy did they remove that fallopian tube?
Traditional myomectomy will only address superficial tumors without entering the endometrial cavity. This might not solve your infertility problem. The scarring caused by FAS (by entering the endometrial cavity) is no different than the scar produced by a traditional c-sections.You are a perfect candidate for the FAS procedure.

I’m a 33 year old who’s had 2 miscarriages. I had my first d&c 08/29/96 and then had a healthy boy in 04/98 and had another m/c and d&c 04/04/00. The doctor told me to go on the progesterone suppositories which I did. I have now developed a cyst on my left ovary which is 1 1/2 inches and my last ultrasound showed a polyp or fibroid in my uterus.

I have to go for another ultrasound next week to determine if it’s a polyp or fibroid. From there surgery is to be scheduled to have another d&c to scrape my uterus in order to remove the growth.

I want to get pregnant again so badly and have another healthy baby.

What do you suggest as a resolution to my problem?

Is surgery the route to go and if so will I then be able to have a successful pregnancy and not have a 3rd m/c?

Patty

Dear Patty-
Unfortunately, there is no way for me to know why you had your miscarriages. Fibroids can effect pregnancies depending on their position in the uterus and their size. If your ultrasound diagnoses fibroids, a D&C will not help you unless they are pedunculated into the endometrial cavity. Most patients have fibroids embedded in the uterine muscle and these must be removed with surgery, more complex than a D&C.

I was told that the location of the fibroid effects fertility? Why is this and what are the worst locations? Can the size of the fibroid damage the uterus and decrease fertility chances even after tumor is removed?

Dear Jamie-
Size and location of fibroids can effect fertility.
Tumors blocking the opening of the fallopian tubes into the uterus, and those effecting the integrity of the endometrial cavity can create infertility.
Removing larger tumors may create scarring in the uterus post surgery and this could effect fertility.

I AM 13 WEEKS PREGNANT AND DISCOVERED YESTERDAY THAT I HAVE A FIBROID TUMOR.I AM SCARED THAT IT IS GOING TO AFFECT THE BABY.WILL IT CROWD THE BABY OR PUT IT IN ANY DANGER?WILL I HAVE TO HAVE A HYSTERECTOMY? I HAVE TO HAVE A CESAREAN FOR THE 5TH TIME. CAN THEY REMOVE IT THEN WITHOUT THE HYSTERECTOMY? PLEASE TELL ME ANY INFORMATION OR DANGER THAT MYSELF OR UNBORN CHILD ARE IN.

Dear Julie-
There is no way for me to accurately answer your questions – I have no idea where your fibroids are located or how many you have. Many women successfully make it through a full term pregnancy with fibroids. Complications can arise, depending on location and size of the tumor(s). Your OBGyn should be able to assist you with some answers. If you are having a scheduled C-Section, ask him if it would be possible to remove the tumor after the delivery. Try not to worry… there is nothing that can be done about your tumors now. Good Luck

dear dr.
I am 24 yrs old: have delivered 3 children naturally: and have been recently diagnosed with a fibroid on my uterus near my right tube. I have been in pain for about 5 months although the cyst itself is only 4 cm. I was scheduled to have the cyst surgically removed when I discovered that I was pregnant.
I am now about 6 weeks pregnant. I am told that it can not under any circumstances be removed during pregnancy. Is there a chance the pain will cease; or get worse; is there anything that I can do while I’m pregnant.

thankyou

Dear j-lynn-
I concur with your doctor. There is nothing that should be done to your fibroid while you are pregnant. There is too great a chance of miscarriage or complications due to anesthesia.
The amount of pain you experience will depend on the location of the tumor and what structures it is compressing.
Once your baby is born, I would recommend removing the tumor.
Good Luck.