Managing fibroids to promote fertility

Medical experts observe that sub-mucosal fibroids develop between the muscles of the uterus, and gradually grow towards the endometrial cavity — mucous membrane that lines the womb.

According to them, sometimes, sub-mucosal fibroids may be attached to the uterus by means of a long stalk, distorting the uterus and interfering with embryo implantation.

Because the fibroids reduce blood flow, they make the lining of the uterus unfriendly to a fertilised egg, they observe further.

Experts also note that sub-mucosal fibroids can alter the lining of uterus, reduce fertility and induce heavy or painful menstrual period or sexual intercourse.

Sanni Oladimeji, a gynecologist with the Ikorodu General Hospital, Lagos State, said fibroids were benign tumours or growths that were harmful to women, observing that the exact cause of fibroids was still unknown.

He, nonetheless, said research had revealed that there was a higher occurrence of fibroids in women who had never been pregnant.

“Fibroids are also more common in women with a family history of the growth, if a mother, grandmother or aunt has had fibroids, it is very likely that another female related to them will also get it,’’ he said.

The gynecologist said rare cases where the growth was malignant; it was not a fibroid but a leiomyosarcoma — a smooth muscle tumour that arises from the muscular part of the uterus.

Oladimeji said the location of the fibroid, speed of growth and its size determined the risks and symptoms perceived by each patient.

He said the growth could be near the fallopian tubes, muscles, uterus wall or even occupy the entire cavity of the womb.

“Symptoms of fibroids include abnormal vaginal bleeding not caused by menstruation; heavy or painful periods, abdominal discomfort or bloating, painful defecation, back ache, urinary frequency or retention.

“The location of the fibroid in few cases, could also prevent a woman from getting pregnant as well as cause a miscarriage, premature labour or interfere with the position of the foetus in pregnancy,’’ Oladimeji said.

He noted that fibroids could be treated either with medication targeted at symptoms or medication that would shrink the fibroid or with surgery to remove it.

Adeoti Oshinowo, a medical expert in Texas, U.S., however said sub-mucosal fibroid caused infertility in woman in several ways.

She said there was a data that suggested that regular exercise and keeping weight under control was good for preventing the growth of fibroids since they were hormones-related.

“Beyond that, there is not much you can do for prevention; the best way to remove the sub-mucosal fibroid is through surgery to improve the chances of fertility.

“Surgery, when recommended by your doctor, can remove fibroids that may be causing fertility problems.

“It is the only treatment for sub-mucosal fibroid that can improve chances of having a baby.

“A cesarean section may be needed for delivery depending on where and how big the incision is,’’ she observed.

She said that after the surgery, the healing process could take up to a year before pregnancy could occur.

She further said that there are some ultrasound ablation techniques that were not recommended for women who desired to get pregnant afterward.

Similarly, Oluwaseun Ojorutemi, a patient of sub-mucosal fibroid at Garki Hospital, Abuja, said she suffered series of miscarriages before the surgery.

According to her, the foetus could not grow beyond eight weeks because the tumour was distorting the lining of the uterus.

She advised woman with sub-mucosal fibroid that are faced with fertility challenge to go for surgery if recommended to increase their chances of giving birth as other types of fibroids do not cause infertility.

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