Fibroid Removal Before IVF - Is It Vital?

Fibroids are small lumps that develop in the muscle layers of the uterus. They are benign which means they will not become cancerous. They are relatively common. 30% of women below the age of 35 years and 20-80% women in the menopausal age bracket are affected by fibroids. They usually appear during the child-bearing years because that is when oestrogen levels peak.

Is surgery necessary?
Whether you need surgery depends on the symptoms. Sometimes the indicators of fibroids are insignificant and do not cause much discomfort. But you might require surgery if the symptoms include-

• Profuse bleeding during periods
• Bleeding even when you are not menstruating
• Intense pain in the lower back or in your abdomen.
• Inability to urinate

Another reason why you might need surgery is certain kinds of fibroids reduce fertility. If you are trying to conceive and you have fibroids, you may find it difficult to become pregnant. And these fibroids also raise risks of miscarriage and labour complications. Moreover, the only remedy in such cases is surgery.

Some Surgery Options-
Your doctor may recommend any of the following procedures-
• Myolysis - The surgeon stops the blood supply to the fibroids during this simple procedure. Without blood and oxygen, they begin to shrivel up and die.

• Endometrial Ablation - This surgery is recommended by doctors when a woman’s period lasts for longer than eight days and is accompanied by such heavy bleeding both during and between periods that it leads to anaemia. During this surgery, the doctor surgically removes the endometrial lining. This is a non-reversible procedure and women cannot conceive after undergoing it. That is why the pros and cons should be weighed carefully before making a decision.

• Myomectomy - This surgery is ideal for women who do not want to eliminate the possibility of conceiving. This surgery does not lead to sterilization. Through either open surgery or laparoscopy, the doctor simply removes the fibroids and leaves the uterus unharmed.

When do you not need Surgery?
You do not need surgery if-
• Your symptoms are tolerable
• The fibroids do not get in the way of conception if you are trying to have a baby
• they are not likely to cause pregnancy complications

Non-Surgical Treatment Options
The most reliable treatment option is medication. Some medicines that your doctor may prescribe are-
• Birth Control Pills-
Birth control pills regulate the hormonal cycle and are very effective in easing the pain and discomfort that accompany periods.

• Non-Steroidal Anti-Inflammatory Drugs or NSAIDs-
Prostaglandins are lipids that are responsible for cramps, pain and heavy bleeding during periods. NSAIDs can inhibit its production and help with period pain. These medicines do not have an adverse effect on fertility.

• Pain medication-
Over-the-counter pain medicines can reduce pain and cramps during menstruation.

• IUDs-
Your doctor may suggest a progestin-releasing intrauterine device. It can keep the symptoms of fibroids under check and help with pain management. But they are not effective if the fibroids are large.

Fibroids can be harmless. But some of them can cause health complications. You should arrive at a decision regarding surgery only after careful consideration of the consequences.