Health

Can uterine fibroids get pregnant? – VnExpress


Uterine fibroids that affect pregnancy do not need to be carefully examined to see where the tumor is located, how much it is, whether it is compressing the uterine cavity or not.

Hello doctor, I am 44 years old and do not have any children yet. I’ve been married since 2005, haven’t had an abortion, haven’t had an abortion, I went to the doctor and said it’s okay. Until 2017, when he examined at the provincial hospital for obstetrics and pediatrics, the doctor said he had multiple fibroids, but he could still make embryos. I made 6 embryos on day 3, transferred embryos 2 times but failed. The third time of embryo transfer, there was beta, but the doctor’s ultrasound said it was many tumors. By the 6th week, the doctor said that the pregnancy is equivalent to 5 weeks, slow growth. By week 7 there will be no fetal heartbeat.

I went to check out some other hospitals, but the doctor said I couldn’t do IVF because I had uterine fibroids and the embryos would be damaged. I have lost hope for 2 years now, I hope the doctors advise me that if the tumor is not treated, will embryo transfer have any effect? The tumor is very large, is it possible to conceive?

Answer:

First of all, I would like to share with you the difficulty you encountered. Through the issues she shared, I would like to emphasize that her case is a difficult one.

As we know, the first factor when doctors consider and predict the outcome of treatment for a patient is the age of the patient. This year she is 44 years old, with the age of over 40, ovarian function will decline, not only in quantity but also in quality. In addition, we see that the results of her previous IVF treatment were also not satisfactory. She had embryo transfer 2 times but the results were not successful.

When implantation failure, especially repeated implantation, we have 3 main groups of causes: the first is due to the uterine cavity, the second is due to the embryo, and the third is due to the reception of the uterine lining. bow with that embryo. Here, we realize that with her case, we need to have a suitable treatment regimen, called personalized treatment to be able to obtain the optimal number of follicles, the optimal number of oocytes to be able to achieve this. get the best number of oocytes.

In addition, she has the additional difficulty of having multiple uterine fibroids. With fibroids, we need to consider where the fibroids are located, what size, and whether they affect the uterine cavity or not? Her case is multiple fibroids, that is, there are many fibroids, so it is necessary to consider very carefully how many fibroids are there and which fibroids affect, and what is the possibility of surgery?

We have treated many cases like you. Many people have fibroids of 3-4cm, which is quite large, but located in a normal position, without affecting the pregnancy process, we still advise patients not to need surgery. But there are cases where the fibroids are very small, about 5-10mm, we recommend surgery. Of course, when performing surgery, we always put the problem of preserving the uterus in an anatomical way, not cutting the fibroids and then damaging the uterus. If the uterus is damaged, there is no other way to get pregnant other than surrogacy.

Therefore, the decision to have surgery or not requires careful examination, and the timing of surgery is also considered because there are times when surgery is not possible. For example, there are times when a fibroid compresses too large and has many blood vessels to feed it, the surgery is very difficult, it is necessary to have a combination treatment so that the fibroid has few blood vessels to supply it. can be shortened, when surgery will be better.

If fibroids really affect the success rate of IVF, then we will have the right intervention. Patients with normal gynecological treatment are only treated for uterine fibroids, but patients come for infertility treatment with the goal of having children. With interventions in IVF treatment, we will try to improve the success rate in IVF. That is the most important goal.

In her case, she is 44 years old and has been doing IVF for 17 years, so we look forward to seeing her as soon as possible and finding the best treatment for her. Your husband should also go to the doctor because sometimes we only care about the wife factor, but we forget the husband also affects and affects the quality of the embryo, which can reduce the success rate.

When you and your wife come to us, we will re-evaluate the results of previous visits and examine the cause, analyze and recommend a treatment plan for you. Hope to see you soon at IVFTA and wish you good news soon.

Assoc.Prof.Dr.BS Le Hoang
Director of the Center for Reproductive Support at Tam Anh General Hospital, Hanoi

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