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Getting Pregnant After Fibroid Removal: Your Path to Parenthood

Best Laparoscopic Surgeon in Dubai
DR ALPHY S PUTHIYIDOM 01 December 2023
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Introduction:


For women dealing with uterine fibroids, the journey to motherhood can sometimes be a challenging one. The size, number, and symptoms of fibroids can significantly impact a woman's ability to conceive, often necessitating fibroid removal surgery. Laparoscopic myomectomy, a minimally invasive procedure, is a popular choice for those seeking to eliminate fibroids while preserving their fertility.

Getting Pregnant After Fibroid Removal: Your Path to Parenthood

If you're among the many women who have undergone laparoscopic myomectomy or are considering this procedure to improve your chances of conceiving, this article is tailored to address your concerns and provide valuable insights. We'll delve into the various aspects of pregnancy after fibroid removal, answering the questions that may be lingering in your mind. Whether you're curious about the recovery process, fertility outcomes, or what to expect during conception attempts, we've got you covered.

Can you still get pregnant after removing fibroids?


Yes, it is generally possible to get pregnant after the removal of fibroids. The ability to conceive and carry a pregnancy to term can be influenced by various factors, including the size, number, and location of the fibroids, as well as the specific reproductive health of the individual. Here are some key points to consider:

Fibroid Size and Location: The ability to get pregnant after fibroid removal depends on several factors, including the size and location of the fibroids.
Submucosal fibroids, which grow into the uterine cavity, are more likely to interfere with fertility. Their presence can affect the implantation of a fertilized egg. The good news is that hysteroscopic removal of submucous fibroids has been successful in improving fertility outcomes in many cases.
Intramural and subserosal fibroids, on the other hand, are located within the uterine wall or on the outer surface of the uterus. While they may have a lesser impact on fertility compared to submucosal fibroids, their effects can still vary depending on their size and number. Removal of these fibroids can be beneficial for fertility in some cases.
So, the possibility of getting pregnant after fibroid removal is influenced by the type, size, and location of the fibroids.

Getting Pregnant After Fibroid Removal: Your Path to Parenthood

Underlying Fertility Issues: It's important to consider other potential fertility issues, such as age, ovarian health, and the male partner's sperm quality, as these can affect pregnancy chances.

Surgical Intervention: Surgical Approach: The process of surgically eliminating fibroids, such as through a myomectomy, can positively impact the chances of becoming pregnant. The effectiveness of myomectomy in enhancing fertility hinges on several factors, including the size and location of the fibroids, their number, and the surgeon's level of expertise as also a major factor.

Post-Surgery Recovery: After fibroid removal, it's crucial to allow time for the uterus to heal and for any scar tissue to resolve. This can impact the likelihood of successful conception.

Individual Variation: Fertility is highly individual, and what works for one person may not work for another. The specific impact of fibroids on pregnancy varies from person to person.


What's the Ideal Timing for Conceiving After Myomectomy Surgery?


Determining the ideal timing to commence attempting pregnancy following myomectomy surgery is based on several key factors, encompassing the type of myomectomy, number and size of the excised fibroids, and the patient's overall health.

1. Different types of myomectomy:

Hysteroscopic Myomectomy:

This minimally invasive procedure involves the removal of fibroids through the cervix. Recovery is generally quick, and individuals can consider trying to conceive within 2-3 months.

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Laparoscopic Myomectomy:

Small abdominal incisions are made to remove fibroids in this procedure. Recovery time is generally longer than with hysteroscopic myomectomy but much less than open abdominal myomectomy. A waiting period of 3-6 months before attempting pregnancy is often recommended, though it varies based on the fibroid location and number.

Open Abdominal Myomectomy:

This procedure entails a larger abdominal incision and an extended recovery period. A waiting period of 6-12 months is commonly recommended before considering pregnancy to ensure proper healing.

2. Number and size of fibroids :

Can influence the recovery period, with more extensive surgeries and the removal of larger or numerous fibroids potentially necessitating a longer waiting period.

3. Monitoring and Follow-Up:

Regular follow-up appointments with your gynecological surgeon important to monitor your progress and confirm that your uterus has healed adequately. Your doctor will provide you the guidance on the optimal timing for commencing pregnancy.

It is important to note that there are no specific guidelines defining the precise interval between myomectomy and pregnancy. Therefore, an individualized approach based on your unique circumstances, as assessed by your healthcare provider, is essential to make an informed decision about the optimal timing for attempting pregnancy after myomectomy.

What happens if you get pregnant right after myomectomy?

Getting pregnant shortly after a myomectomy (surgical removal of uterine fibroids) can be associated with certain risks and considerations, but the actual outcome can vary depending on individual circumstances.

The potential risks and factors to consider:

Uterine Healing:

After a myomectomy, the uterus undergoes a healing process. The surgery can create scar tissue in the uterine wall. If pregnancy occurs soon after the procedure, there is a risk that the uterus may not have fully healed, which can lead to complications. The exact timeframe for optimal healing can vary depending on the type of myomectomy performed, the size and number of fibroids removed, and individual healing rates.

Increased Risk of Uterine Rupture::

One of the main concerns when getting pregnant shortly after a myomectomy is the increased risk of uterine rupture during pregnancy or labor. Uterine rupture can be life-threatening for both the mother and the baby. The risk of uterine rupture is generally higher for pregnancies within the 3 months after a myomectomy, particularly for certain types of myomectomy, such as a large and multiple transmural fibroids, which involve deeper uterine incisions.

Each situation is unique, so decisions regarding the mode of delivery after fibroid removal should be made in consultation with your gynecological surgeon, taking into consideration the specific characteristics of the fibroids and the surgical procedure.

Is it possible to have a natural birth after undergoing fibroid removal, also known as myomectomy?

This likelihood hinges on various factors, including the size, location, and number of fibroids, as well as the specific surgical approach employed.

Subserosal and Pedunculated Fibroids: Subserosal fibroids, those situated on the outer uterine wall, and pedunculated fibroids are less likely to impede pregnancy and childbirth, making natural birth a viable option.
Submucosal Fibroids: Submucosal fibroids that protrude into the uterine cavity and are removed through hysteroscopy, with minimal impact on the uterine wall, also offer the potential for a natural birth.
Intramural Fibroids: In cases where intramural fibroids, which reside within the uterine wall, necessitate deep incisions, caution should be exercised when attempting natural birth due to the increased risk of uterine rupture.

Each situation is unique, so decisions regarding the mode of delivery after fibroid removal should be made in consultation with your gynecological surgeon, taking into consideration the specific characteristics of the fibroids and the surgical procedure.

Is Cesarean Section necessary after myomectomy?

Delivery options following both open and laparoscopic myomectomy remains a controversial topic and opinions vary between obstetricians and gynaecologists. The main concern remains the small, but potentially catastrophic risk of uterine rupture. The decision of cesarean section or normal vaginal delivery is decided on many factors


Factors that could affect the integrity of the uterus post myomectomy.


Number of fibroids removed.

The number of uterine incisions

The size of the fibroids removed.

The location of the fibroids removed.

Technology used for haemostasias (either electrocautery - bipolar/ monopolar coagulation more tissue damage or modern ultrasonic devices).

Type of suture used and number of layers of closure.

Hematoma (blood collection) development after myomectomy

In summary, whether you should have a cesarean section or a normal vaginal delivery after myomectomy depends on various factors mentioned earlier. The main aim is to reduce the risk of uterine rupture. It's crucial for your obstetricians and gynecologists to carefully assess your situation and make a personalized decision. When you leave the hospital after your fibroid removal surgery, make sure to get detailed information about your operation. Nowadays, laparoscopic and robotic surgeries are recorded, so you can ask for a copy of surgery video. Your obstetrician can review it to determine the best delivery method for you.

Dr Alphy S Puthiyidom

MBBS, MD(Obs&Gn),FMIS(Laparoscopy)
Head of the Department
Advanced Gynecological Laparoscopic Surgeon & Pelvic Reconstructive Surgeon
MEDICLINIC WELCARE HOSPITAL
Al Garhoud, Dubai
MEDICLINIC PARKVIEW HOSPITAL
Umm Sequim, Al Barsha South 3, Dubai
Appointments 800-1999
www.mediclinic.ae

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