Do you always need a fibroid surgery?
Fibroids are benign (rarely cancerous) tumours of the uterine smooth muscles. They occur in 1 in 4 females and common around the reproductive age group. The exact cause of fibroid is unknown but estrogen is suspected to play some role. It is however commoner amongst blacks, obese females, women of low parity and relatively infertile women and may be familial.

Uterine fibroids are usually without symptoms with only 25% of individuals with fibroids manifesting with symptoms. Symptoms include heavy menstrual flow, irregular menses, pain during menstruation, increase in abdominal size, abdominal pain, chronic pelvic pain, recurrent abortions and occasionally pressure symptoms such frequent urination. It has also been associated with infertility. However, the mere presence of fibroid may not be the cause of infertility.

Despite the enormous evidence that the mere presence of fibroids is not causally linreproductive2ked with infertility, myomectomy (surgical removal of fibroid) is still usually performed when uterine fibroid is found in association with infertility. Mechanism by which uterine fibroids cause infertility include distortion of cavity or inner lining of the womb, impairment of blood supply to the endometrium, dysfunctional uterine contractility and it may increase surface area and invariably a longer distance for sperm to travel.

Myomectomy is a fertility enhancing procedure and crude pregnancy rate after myomectomy is between 38% – 65% with majority conceiving within 6 months of the procedure.
Of utmost importance is the endometrial lining, the integrity of which must always be preserved at surgery. Most fertility experts will only carry out a fibroid surgery if the endometrium is being distorted by the fibroids.

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Currently, fibroids are known to cause pain in pregnancy (from red degeneration) and the view of fibroids causing miscarriage

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