Topics of Interest

Myomectomy and Fertility

Dear Dr Parker,

I was first diagnosed with fibroids back in 1998 at the age of 28 after a routine ultrasound scan. The fibroid then measured 3cm and the DR also noticed other very tiny ones and advised that i should start having children soon or i might find it difficult to conceive. Subsequently i have been going to my local hospital and they have been monitoring its growth. In 2004 it was revealed that the fibroids were about three but the DR said that since they are not growing where the baby is supposed to grow that he is not worried.

In 2007/2008 i went to the hospital and had another ultrasound scan that reveal more fibroids and the fibroids measured about a 20 week size uterus. The risks of surgery were pointed out to me and this scarred my off. My periods have also become very heavy over the last three years and since last year i started noticing blood clots during my periods. My periods last 5 days and by the 6th day its over, i do not bleed in between my periods. My abdomen appears big.

In October 2010 my haemoglobin dropped to 7.5 and i was anaemic and put on Iron supplements, i had an MRI scan that revealed mutiple fibroids – intramural, submucosal and subserosal the biggest measuring 6.2.

The first gynaecologist i saw recommended UAE since i was scarred of surgery, but i later discovered that this may not be advisable for women still desiring children. So my GP referred me to another gynaecologist for a 2nd opinion and i was told that even having a myomectomy now would not be beneficial due to the number of fibroid, that my uterous has been distorted by the multiple fibroids so it will be difficult for me to conceive but i insisted that maybe it will be okay to remove the large troublesome ones and was then told that i had to lose a lot of weight, i currently weigh 92kg but had to drop to 80kg before i could undergo the surgery. I am now open to having a myomectomy but what would you suggest. I would ideally like to have a baby in the next year or so.

I have researched extensively on the internet and seen that women whose cases are worse than mine have succesfully undergone myomectomies even removing as much as over 30 fibroids and still had successful pregnancise

Please what would you advise or is it too late.




You can certainly have a myomectomy and, with an experienced surgeon, pregnancy should be feasible after 3 months.  However, the main issue for you will be that natural fertility declines with age.  If you are willing to undergo IVF or even use donor eggs then myomectomy may be worth the time, expense and recovery.  You should consider seeing a fertility doctor before surgery so that you have a plan right after surgery if you want to get pregnant.  The longer you wait the more difficult getting pregnant will be.

Bill Parker, MD


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