A uterine fibroid prevents pregnancy

Uterine fibroids: implications for pregnancy


Uterine fibroids are benign tumors that are usually characterized by hormone-dependent growth and contribute to about 20 to 40% of women occur over 30 years. Since the tumors in the muscle layer of the uterus do not cause any symptoms in many cases, they are often discovered by chance or only after the onset of pregnancy.

With smaller fibroids, no effects on fertility or the course of pregnancy are to be expected. Depending on the location, size and number of the uterine fibroids - apart from general complaints and risks - there are also impairments to fertility and pregnancy.

 

Uterine fibroids:

Complaints and risks

Effects on Pregnancy

Uterine fibroids: treatment options

Frequently asked questions

 

Complaints and risks


Provided Uterine fibroids discomfort cause, these are usually expressed in bleeding disorders, pain or a feeling of pressure in the pelvis. Fibroids can also be the reason for an unfulfilled desire to have children.

Subserous fibroids, so fibroids that are on the outer wall of the uterus, do not affect fertility. However, above a certain size or when they cause discomfort, subserous fibroids should also be removed before pregnancy. The same applies to intramural and submucosal myomas.

Intramural fibroids lie in the uterine wall and can impair fertility if they are a certain size or if they are in front of the fallopian tubes. Regardless of their size, submucosal myomas that grow into the uterine cavity generally impair the implantation of the embryo and the course of pregnancy.

 

Effects of fibroids on pregnancy


Not all fibroids cause complications in pregnancy. Since uterine fibroids occur more often between the ages of 30 and 40 years and more and more women have family planning in this decade of life, fibroids are important for the Course of pregnancy increased.

Basically: The bigger the fibroid is, the more likely are Complications during pregnancy. In individual cases, the increased estrogen level during pregnancy can stimulate myoma growth and thus cause pain and a feeling of pressure or lead to positional anomalies in the child or the placenta. This may then require a caesarean section.

In the first trimester of pregnancy, large fibroids can also affect the growth of the embryo so badly that it becomes one increased rate of miscarriages comes. In very rare cases, fibroids can block the birth canal due to their location and require a caesarean section. Fibroids also increase the risk of premature labor and heavy bleeding during or after childbirth. However, damage to the child in advanced pregnancy is rare.

 

Uterine fibroids: treatment options


If you wish to have children, existing fibroids should be checked for imaging Procedures such as ultrasound and MRI be judged accurately. This makes it possible to assess whether the implantation of the embryo and the course of embryonic development may be impaired.

 

Operative removal


Surgical removal of the fibroids (myoma nucleation) during pregnancy is also possible high risks hand in hand. The embryo can be seriously damaged by the procedure - for this reason, myoma nucleation should be avoided. Hormone therapies are also unsuitable during pregnancy. When diagnosing large or numerous fibroids, careful removal before the onset of pregnancy is advisable.

 

Treatment with MRgFUS


Treatment with is particularly gentle and low-risk MR-guided focused ultrasound waves. Ultrasound waves are bundled and the fibroid is cooked off with heat. The surrounding tissue is not injured with this method. The uterus remains fully functional. Follow this link for more information on MRgFUS therapy for fibroids.

In contrast, the operation creates a scar that can become a “weak point” on the wall as an embryo grows and matures. If this is the case, there is a risk of premature birth or premature termination of the pregnancy.

 

Medication


Through a drug Treatment of fibroids with hormones should be influenced in a targeted manner on their size. As a rule, drug treatment is therefore used in preparation for an operation on the uterus.

Since hormone treatments require regular individual adjustment and different preparations are available, no generally binding recommendations can be made. The best thing to do is to ask your treating gynecologist.

 

Fibroid embolization


Myoma embolization is one way of successfully shrinking fibroids. The blood vessels that supply the fibroid will be via a catheter with very small particles locked. To do this, a thin catheter is inserted into the inguinal artery and guided into the arteries of the uterus under X-ray control. Particles are injected through the catheter that cause thrombosis in the arteries. As a result, this leads to the death of the fibroid. The dead tissue is then broken down by the body.

Myoma embolization is not suitable for those wishing to have children and is only offered if other treatment methods are not available. It cannot be ruled out that even small vessels in the normal uterine wall are closed during the procedure. However, these are needed for the growth and increased blood requirements of the uterus when an embryo matures and grows. An insufficient supply of blood to the uterus can lead to premature termination of pregnancy or miscarriage.

The procedure can also affect the ovaries or the Uterus itself injured become. While these complications are rare, they can lead to complete infertility.

 

Myoma Enucleation


With myoma enucleation, fibroids are removed by means of a minimally invasive abdominal mirror while preserving the uterus. Deep-seated fibroids can also be removed via an abdominal incision. In this case, however, the recovery time after the surgery will be longer.

Myoma enucleation creates a scar in the wall of the uterus. This scar is a weak point and can affect a subsequent pregnancy.

 

Frequently asked questions


Can you get pregnant with fibroid?

Typically, fibroids do not interfere with your ability to become pregnant. However, if the location is unfavorable, above a certain size or if there are several myomas, the implantation of the embryo can be impaired or prevented. If the desire to have children persists or repeat miscarriages, fibroids should therefore be removed.

 

When can you get pregnant after myoma surgery?

After an operative myoma removal, pregnancy should not be planned for 6 months at the earliest. This gives the body enough time to allow the scar in the uterus to heal. However, we recommend that you clarify the exact time with your gynecologist.