The Center for Fertility and Gynecology in Los Angeles is a comprehensive fertility center with experience in all aspects of fertility care. From technologically advanced treatments such as IVF, ICSI and PGD to precise surgeries such as tubal reversals, laparoscopies and myomectomies, the doctors and staff at CFG can help you to achieve your reproductive goals.
What is a fibroid?
Fibroid tumors, or leiomyomas, are benign growths arising from uterine tissue. Fibroids are incredibly common throughout the population and are known to exist in up to 60% of women in some ethnic groups. Fibroids begin as a single cell type and grow in a mostly spherical pattern throughout the uterus. While most fibroids are 1-6 centimeters in diameter, there are reports of fibroids growing to multiple feet in diameter and weighing more than 20 pounds! Fibroids can be encountered as a single tumor or as many tumors throughout the uterus.
Size does matter
Fortunately, most women with fibroids have no symptoms. This is because fibroids only cause problems if they are either large or located in a specific area of the uterus. If a fibroid is large, it can cause problems by distorting the shape of the uterus, pressing on neighboring organs within the abdomen or exerting pressure within the pelvis. This is often perceived as vague pain or fullness within the lower abdomen. Additionally, a large fibroid may cause intercourse to be uncomfortable or lead to heavy, painful menses.
Location, location, location
While the size of a fibroid is important, location truly determines if a fibroid is symptomatic. If a fibroid is located within or just below the endometrial cavity, the area where an embryo would implant, it can lead to heavy periods and infertility. Even a very small fibroid located within the endometrial cavity can cause blood clots, severe uterine cramping and infertility.
Myomectomy, (surgical removal)
The surgical approach to remove a fibroid depends on several factors including size, location, numbers and patient wishes. Some approaches include the following:
Open myomectomy: A small “c-section” style incision is made in the lower abdomen and the fibroids are manually removed using precise surgical technique. Patients with very large fibroids, multiple fibroids and those interested in future fertility are good candidates for this procedure. The benefit of this approach is that the surgeon can “feel” the how deep the fibroids are and can close the incisions in the uterus securely.
Laparoscopic myomectomy: Multiple small incisions are made in the abdomen and fibroids are removed using a camera and laparoscopic instruments. The advantage of this procedure is that the recovery time is shorter and the incision on the abdomen is smaller. Sometimes this approach is modified by using a robot. The some surgeons believe that robot improves precision.
Hysteroscopic myomectomy: Hysteroscopy is the technique of placing a camera into the uterus through the cervix. Fibroids within the endometrial cavity can be removed by this method. The advantage is that there are no incisions on the abdomen and the recovery is short. Unfortunately, only specific types of fibroids are amenable to hysteroscopic removal.
If you have fibroids or other questions about reproduction, please contact us, one of our fertility specialists will be happy to speak with you.