Fibroid uterus

Fibroids are also known as myomas or leiyomyaomas. Fibroids are smooth mucle tumors of the uterus. They are the most common tumors of the uterus and the female pelvis. These are benign.

The prevalence of fibroids increase with age in the reproductive years and is about 40% after the age of 40 years.

Fibroids are of 3 types, according to their location:

Submucous- a fibroid which grows beneath the uterine lining

Intramural- a fibroid which grows mainly within the wall of the uterus

Subserous- a fibroid which grows toward and beneath the outer surface of the uterus

The symptoms depend on the size, site and number of fibroids. Most fibrois are small and do not cause any symptoms.

-    Menstrual disturbances

-    Pelvic pain

-    Abdominal lump

-    Subfertility/Infertility

-    Pregnancy related problems

Fibroids account for 2-3% of infetrility cases.

Mechanism:

-    Distortion of anatomy causing interference with sperm transport

-    Impingement of the fibroid on the cervical canal or fallopian tube

-    Endometrial changes- ulceration, altered vascularity, polyps
Most fibroids in infertile women do not need any treatment, because they do not affect fertility or pregnancy.

However, submucous fibroids in infertile women ( those within the uterine cavity or causing distortion of the cavity ) need to be removed. These are best removed by an operative hysteroscopy.

‘Myomectomy’ the procedure for removing fibroids can be done through an open surgery or laparoscopically. This may not be beneficial in infertile women unless the fibroids are very large.