Our Summary

This study was conducted to identify the best methods for removing fibroids (myomas) from women who wish to become pregnant in the future. The research team looked at various factors including how the surgery was conducted, the patient’s age, the number of fibroids, and whether the fibroids were distorting the uterus.

They reviewed previous studies on the subject, focusing on women of childbearing age who had undergone surgery to remove fibroids. They looked at various outcomes such as the woman’s fertility post-surgery, pregnancy rates, and pregnancy outcomes.

The researchers found that women who were younger, had fewer fibroids, and whose fibroids were not distorting the uterus had better outcomes after surgery. The method of surgery, whether it was performed through a large incision in the abdomen or less invasive methods, and the use of a procedure to block the blood supply to the uterus during surgery, didn’t significantly affect the chances of getting pregnant or the outcome of the pregnancy.

The researchers concluded that more studies are needed to better understand the relationship between the characteristics of the fibroids (such as their size and location) and the chances of becoming pregnant and having a successful pregnancy. They also suggested that the use of barriers to prevent tissues from sticking together after surgery could be an area for further research.

FAQs

  1. What factors were considered in the study to identify the best methods for removing fibroids?
  2. What were the main findings of the research regarding the factors that affect pregnancy after a myomectomy?
  3. What are the areas that the researchers suggested need further study in relation to myomectomy and future pregnancies?

Doctor’s Tip

One helpful tip a doctor might give to a patient considering myomectomy is to discuss their future fertility goals and desires with their healthcare provider. This will help the doctor tailor the surgical approach and postoperative care to optimize the patient’s chances of getting pregnant in the future. Additionally, it’s important for the patient to follow their doctor’s recommendations for postoperative care, including any medications or lifestyle changes, to ensure a successful recovery and optimal fertility outcomes.

Suitable For

Overall, patients who are typically recommended for myomectomy are women of childbearing age who are experiencing symptoms such as heavy menstrual bleeding, pelvic pain, and pressure, and who wish to become pregnant in the future. Younger women with fewer fibroids that are not distorting the uterus are more likely to have successful outcomes after surgery. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if myomectomy is the best treatment option for them.

Timeline

Before myomectomy:

  • Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and infertility.
  • Patient undergoes diagnostic tests such as ultrasound, MRI, and hysteroscopy to confirm the presence of fibroids and evaluate their size and location.
  • Patient discusses treatment options with their healthcare provider, including myomectomy as a surgical option to remove the fibroids while preserving the uterus.
  • Patient may undergo preoperative testing to assess their overall health and readiness for surgery.

After myomectomy:

  • Patient undergoes the surgical procedure to remove the fibroids, either through a large incision in the abdomen (abdominal myomectomy) or minimally invasive methods such as laparoscopic or robotic-assisted surgery.
  • Patient may stay in the hospital for a few days for recovery and monitoring.
  • Patient experiences postoperative pain, fatigue, and possible complications such as infection or bleeding.
  • Patient follows up with their healthcare provider for postoperative care and monitoring.
  • Patient may experience improvements in symptoms such as reduced menstrual bleeding and pelvic pain.
  • Patient may need to wait a few months before trying to conceive to allow the uterus to heal properly.
  • Patient may have improved fertility and a higher chance of successful pregnancy post-surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy include:

  1. What are the potential risks and complications associated with myomectomy surgery?
  2. How will my fertility be affected by the surgery, and what are the chances of getting pregnant after the procedure?
  3. Will the size and location of my fibroids impact the success of the surgery and my future fertility?
  4. What are the different methods of myomectomy available, and which one is the most suitable for my specific case?
  5. How long is the recovery period after myomectomy, and what can I expect in terms of pain and discomfort?
  6. Will I need to undergo any additional treatments or procedures to increase my chances of becoming pregnant after the surgery?
  7. Are there any lifestyle changes or medications I should consider before or after myomectomy to optimize my fertility?
  8. What are the chances of the fibroids recurring after surgery, and how can I prevent this from happening?
  9. Are there any alternative treatments or therapies that I should consider before opting for myomectomy?
  10. Can you provide me with information about your experience and success rates with myomectomy procedures for women who wish to become pregnant in the future?

Reference

Authors: Orlando M, Kollikonda S, Hackett L, Kho R. Journal: J Minim Invasive Gynecol. 2021 Mar;28(3):598-618.e1. doi: 10.1016/j.jmig.2020.10.006. Epub 2020 Oct 14. PMID: 33065260