Dr.sathya balasubramanyam

MD DNB MRCOG (UK) FNB(Reprod med)

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UTERINE FIBROIDS AND INFERTILITY - TREATMENT

Affecting about 25% of women worldwide, fibroids are common among women in the childbearing ages. Fibroids are non-cancerous and benign tumours found in the uterus of a woman. Also called myomas or uterine leiomyomas, they grow in the muscle cells of the uterus. They may protrude inside or outside of the uterus and are known to contribute to infertility in some cases.

Fibroid Removal

Types of Fibroids

Fibroids are classified into different types based on the location of growth, as follows: -

  • Submucous fibroid – fibroid that grows under the uterine lining

  • Subserosal fibroid – fibroids that grow on the outer surface of uterus

  • Intracavitary fibroid – fibroids that grow inside the uterine cavity

  • Intramural fibroid – fibroids that grow inside the muscular walls of the uterus

  • Pedunculated fibroid – fibroids that are attached to the uterus by a thin stalk

Symptoms of fibroids

The symptoms of fibroid growth are usually associated with the number, size and location of growth. In most cases, fibroids are small and do not manifest any symptoms. However, in some, they cause symptoms that interfere with their daily life.

Fibroids can cause infertility in many ways. The growth of fibroid near the fallopian tubes can cause a compression in these tubes that restrict the passage of eggs or sperms blocking the chances of fertilisation. A fibroid that is large in size has the potential to distort the anatomy of the pelvic area, hampering fertility. Those that protrude into the uterine cavity can create a barrier for implantation, as well.

The location of fibroid is known to affect pregnancy as well. Women with large fibroids often face miscarriages, labour difficulties, abruption placenta where the placenta separates from the walls of the uterus during pregnancy and premature rupture of the amniotic sac. Other symptoms of fibroids include increased uterine bleeding and pain in the pelvic region.

Diagnosis of Fibroids

Large fibroids can be detected by a routine pelvic exam. However, we make use of ultrasound for the accurate diagnosis of the fibroid, its location and size. Other methods for the detection of fibroids include hystero-sonogram, hysterosalpinogram, hysteroscopy and MRI (Magnetic Resonance Imaging).

Uterine Fibroid Treatment

The treatment for uterine  fibroid is dependent on many factors such as the medical history and health of the patient, the location and size of the fibroid and the preference of patient undergoing the treatment.

The various treatments include the use of GnRH agonists and anti-hormonal agents in controlling the hormonal activity that is known to contribute to fibroid growth. Conservative surgical procedures are also used for the removal of largely sized fibroids, keeping the uterus and associated organs intact.

Uterine fibroid embolization is a newer minimally invasive procedure for fibroid treatment which involves cutting down the supply of blood into it, effectively stunting its growth and shrinking it.

 

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DR.SATHYA BALASUBRAMANYAM

Dr. Sathya Balasubramanyam

MD DNB MRCOG (UK)
FNB(Reprod med)

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