Category: Fibroids and Pregnancy

Surprise: Fibroid Surgery Doesn’t Help Fertility

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Fibroid tumors are non-cancerous growths that develop in and on a woman’s uterus. While not a life threatening condition, because of their location, they can cause many negative symptoms, including problems with fertility, menstruation, and your bowel and bladder function. Hysterectomy procedure

Women who have fibroids but still want to have children are often told surgery is their only option. The surgical removal of a fibroid tumor (myomectomy) was thought to be a woman’s best option if she wanted to get pregnant. Now, new research is changing everything. 

Myomectomies Don’t Improve Fertility

A new review in the Cochrane journal says: “one study…that examined the effect of myomectomy on fertility and it found no significant benefit.” In other words, even if you have surgery to remove your fibroid tumors, your chances of getting or staying pregnant may not improve. 

Of course, this is just one stud; more research is needed to really prove the effect of fibroid surgery on fertility. It does, however, mean that women should carefully consider all their treatment options before rushing into surgery just to preserve their fertility dreams. 

UFE and Pregnancy

Patients with fibroids  who hope to get pregnant may also consider uterine fibroid embolization, a minimally invasive procedure that effectively kills fibroids by cutting off their blood supply. Many patients wishing to avoid myomectomy want to know if they can become pregnant after uterine fibroid embolization. There have been reports of many successful pregnancies in patients after UFE. Many studies show that fertility rates and miscarriage rates in UFE patients are no different than patients of the same age with fibroids who have had no treatment. That being said, patients may be better off having a myomectomy if they are a good candidate and are willing to undergo surgery.

Although the findings are not clear cut, a few studies have shown that pregnancy complications may be slightly more common after UFE compared with myomectomy. These pregnancy complications can include pre-term labor and pregnancy induced hypertension, also known as pre eclampsia. UFE might still be an option in patients who are not good candidates for myomectomy or who do not want to have surgery. All this will be especially true if it turns out that myomectomy really can’t improve your fertility. 

How Fibroids Can Affect Your Fertility

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Those non-cancerous tumors made up of cells and muscle known as fibroids can be a quirky lot. Many women with uterine fibroids have no symptoms whatsoever, and some never even know they have them. Others have painful and heavy periods and struggle with discomfort. With all these disparate situations you may be wondering if and how fibroids can affect your fertility.

Continue reading “How Fibroids Can Affect Your Fertility” →

#WCW: Bravo Star Talks Fibroids and C-Sections

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If the name Kenya Moore, star of Bravo’s Real Housewives of Atlanta, is becoming familiar to you, that’s because she’s been our Woman Crush Wednesday a few times already: she’s been incredible about sharing her difficulties in becoming and staying pregnant due to her fibroids. Well now, once again, she’s earning a #WCW spot of honor as she publicly addresses another potential fibroid obstacle: delivering your baby while you still have uterine fibroids. 

Back in October, pregnant Moore was hospitalized. Shortly afterwards, she reveled that she’d need to deliver her daughter, Brooklyn, early because she had preeclampsia, a condition that causes pregnant women to develop extremely high blood pressure. While that diagnosis was challenging enough, Moore revealed is now revealing that her delivery was also difficult.

In a new interview with People magazine, Moore explained that she had to have a three-hour emergency cesarean section and, because she had uterine fibroids, she couldn’t get away with a discreet incision: instead, doctors had to create both horizontal and vertical incisions

“They couldn’t get the baby out,” she shared. “There were all these complications and they knew if they cut into a fibroid, I could potentially bleed out and die. So they ended up cutting me vertically, too, to just get the baby out and make sure I survived the surgery. They were so scared they were going to lose me.”

Even worse? Moore revealed that her epidural ran out at one point, so she needed to go under general anesthesia to avoid excruciating pain. “When it was all over, my doctor said, ‘This was one for the books,’” Moore said. Thankfully, despite being delivered six weeks ahead of schedule, Brooklyn is healthy, and Moore has recovered enough to tell her story. 

Pregnancy and Delivery with Fibroids

Unfortunately, pregnancy and delivery complications are not uncommon in women with fibroids.

These benign, muscular growths develop in and on your uterus, causing many potential side effects (including pain, heavy periods, vaginal bleeding when you’re not on your period, painful sex, and problems conceiving or carrying a child to term.) 

While some women experience completely typical pregnancies, women with fibroids are more likely to need a C-section, to have a breech baby , to have non-progressive labor, to have their placentas break away from the wall of the uterus before delivery (placental abruption), or to deliver their babies prematurely.

Women with fibroids that block their cervix will almost always have to deliver babies via c-section–their fibroids block the fetus’ only other exit strategy. And, as Moore demonstrates so vividly, fibroids can make c-sections a little more complicated. 

C-Sections with Fibroids

Fibroids often get bigger while you’re pregnant, and large fibroids can make it difficult for doctors to enter the uterus to deliver your baby. Also, because fibroids have a significant blood supply that feeds them, cutting a fibroid during surgery can make a women lose even more blood, which can become a life-threatening condition during delivery. 

Fortunately, if you’re aware of your fibroids–and the potential complications they may cause during delivery–you should still be able to deliver a healthy baby, just like Kenya Moore. The important thing is to discuss your options, and potential outcomes, with your physicians so you can come up with the safest possible delivery plan for you and your child.

#WCW: Kandi Burruss Explores Surrogacy After Fibroids

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Recently, Real Housewives of Atlanta star Kandi Burruss opened up about her journey to expand her family. The reality star already shares two children with husband but is now considering surrogacy as an option. She shared her reasons with the entire country, on Bravo TV, on the November 25 episode of her show. For her bravery, we’ve nominated Kandi as our Woman Crush Wednesday honoree! 

On that episode, Kandi is seen at an OBGYN appointment with Dr. Jackie Walters. They talk about the complications she experienced when pregnant with Ace, her now-2-year-old son. Even though Kandi had surgery to remove fibroids before conceiving Ace through IVF, she thinks some fibroids remained. Because of those fibroids, she says, ” [I had] a couple of scares during my pregnancy with Ace. I was a high risk and I did have bleeding a few times.”

Fibroids during pregnancy can certainly affect a mother’s ability to carry her child to term. Depending on size and location, uterine fibroids can lead to pre-term labor or miscarriage, if a woman is able to conceive at all. 

While Kandi was previously able to conceive with fibroids, she has not been as lucky while trying to have a third child. “I know there was still some fibroids after pregnancy,” she says. “I feel like it got worse because Ace is two now and [no conception is] happening.”

Ultimately, Kandi accepted the fact that she will not carry another child herself: “My womb is just, it’s not the best place to have a healthy pregnancy with no issues,” she admitted to her doctor. Still, she’s not ready to give up on her family dream, so Kandi is looking for a surrogate to carry the two remaining embryos she has from going through the IVF process. 

For women who still want to have families, dealing with fibroids can be a challenge. There’s no way around that fact. But what strong women like Kandi Burruss are proving is that fibroids don’t have to derail your plans. There are multiple treatment options available and many different ways to complete your family. All you need to do is stay open to possibilities, and work with your fibroid specialists to find the plan that works best for you and your family. 

 

 

Why Location Matters When it Comes to Fibroids

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If you’ve been diagnosed with uterine fibroids, it means you have abnormal growths (made up of muscle cells and fibrous tissues) in your uterus. These fibroids are non-cancerous, and can vary in size and location. And while fibroids in any location have the potential to cause uncomfortable side effects, fibroids in certain locations will affect your ability to conceive more than others. 

Fibroids that grow mainly  away from the uterine cavity are called subserosal. Fibroids within the muscle wall are called intramural. Fibroids that grow into the uterine cavity are called submucosal. While having fibroids doesn’t mean you can’t get pregnant, submucosal and intramural fibroids can make it difficult to become pregnant or carry your child to term. Pregnant women usually wait to begin treatment until after they’ve delivered, but if you’re having trouble conceiving, seeking immediate treatment is a good idea.

Obviously, a fibroid that is inside the uterine cavity (submucosal) is most likely to impact conception, but large masses in any location can also cause problems. In fact, a submucosal fibroid can make it 70% harder for a woman to get pregnant!  Large fibroids take a toll on fertility in a variety of ways: they can change the shape of your uterus and cervix, or they can block or slow down the movement of a man’s sperm or a fertilized embryo. They can also block your fallopian tubes from releasing eggs, or affect the quality and thickness of your uterine lining. 

For all these reasons, women who know they have fibroids should consult with their doctors before trying to get pregnant. Even if immediate treatment is not necessary, knowing the size and location of your fibroids will help you make informed decisions throughout your conception and pregnancy journey. It’s also important to let your fibroid specialist know about future family planning, as the course of treatment he or she recommends may differ based on your short and long term pregnancy goals.

Six Problems That Could Hurt Your Fertility

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Regardless of whether you want to have a child, your fertility is an important part of female health. It’s therefore so important to understand medical conditions and external factors that could cause female infertility. Here are six of the top culprits to explore for possible causes if you’re dealing with infertility: 

1. Problems with fallopian tubespain from uterine fibroids

When functioning properly, your fallopian tubes act as a highway for your eggs. During ovulation, eggs travel down the tubes; if an egg meets sperm at the end of its journey, it can become a fertilized embryo. If, however, your fallopian tubes become blocked or damaged, sperm can’t meet your eggs. And even if the sperm and egg do connect, the fertilized embryo will have a harder time travelling to your uterus for implantation.  While many things can cause damage to your fallopian tubes, PID (pelvic inflammatory disease) and STIs or STDs are often responsible.

2. Endometriosis

Endometriosis is a painful condition in which endometrium, the tissue that’s normally found in the lining of your uterus grows outside the uterus. Often, this misplaced tissue develops in your ovaries or fallopian tubes. Endometriosis can be painful. It affects your menstrual cycle and, often, your ability to conceive.

3. PCOS

PCOS, or Polycystic ovarian syndrome, is a hormonal disorder that causes your ovaries to become enlarged and covered in cysts at their edges. Another characteristic of this condition is that women produce more male hormones than is typical. Approximately 10% of women are affected by PCOS. Symptoms include irregular menstrual cycles, obesity, excess hair growth, higher risks of diabetes and acne.

 4. Uterine fibroids

Uterine fibroids are non-cancerous tumors that develop in or on your uterus. Fibroids can develop inside your uterus, on its lining, inside its wall or even on the outer surface of your uterus. Fibroids can affect your menstrual cycle, your ability to conceive and your ability to carry a successful pregnancy to term.

5. Thyroid conditions

Thyroid hormones regulate, among other things, fertility and pregnancy in as much as they are a major part of human growth and development. Hypothyroidism, a condition in which your thyroid hormone levels are low, can stop your ovaries from releasing eggs for fertilization.

 
6. Egg problems

Every woman has a different number and quality of eggs that may be produced by her ovaries. Some women have fairly low egg counts. Other women have plenty of eggs, but the ones she has are not up to the task of creating a baby.  Egg count and quality decrease with age, so women with advanced maternal age may be inclined to check their egg quality when grappling with infertility.

 

Unfortunately, many different causes of infertility manifest with the same symptom—irregular or heavy menstrual cycles. In many cases, you can only pinpoint the cause of your infertility by ruling out all other possibilities. If you are concerned that fibroids may be the cause of your infertility issues, schedule a consultation with Dr. Fox or Dr. Hardee in our Houston area fibroid clinic today.

 

 

#WCW: Porsha William’s Pregnancy with Fibroids

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For years, Real Housewives of Atlanta Star Porsha Williams has kept quiet about her struggle with fibroids. Even when it hurt her attempts to get pregnant. But now that the Bravo star is expecting her first child, she’s opening up about her journey. Her decision to share this story makes her our very special Woman Crush Wednesday of the week! 

When Ms. Williams was married to her ex-husband, Kordell Stewart, she suffered a miscarriage and then tried for six years to get pregnant again. During this difficult period, Porsha found out she had uterine fibroids (non-cancerous tumors that grow in the uterus) that could be affecting her ability to carry a baby. Because of her age and hopes for a family, Porsha sought fertility-saving treatment. She ultimately had a myomectomy–a surgery that removed her fibroid but kept her uterus in place and in tact. 

While her marriage ended, her hopes for a baby did not and, just recently, she proudly announced that she’s expecting her first child with boyfriend Dennis McKinley. While her story end happily, Porsha admits that it’s been a tough road for the couple. 

“It’s something we’ve both always wanted,” Porsha told People magazine, also sharing that McKinley’s “probably shed more tears during the process than me.” 

Fear and Joy
Even hearing that she was finally pregnant was a tense moment for Porsha. On the way into her first pregnancy scan, she wondered, “Because I suffer with fibroids and had to have a myomectomy [I kept thinking] ‘Is the baby going to be okay? Will I make it full term?’ All those questions that you ask if you’ve had a miscarriage before.” 

Thankfully, Porsha’s pregnancy seems to be progressing well, and she and Mr. McKinley look forward to welcoming their child in 2019. As Houston fibroid doctors who work to give women alternatives to hysterectomies, we love hearing stories like Dennis and Porsha’s. Too many women believe that they must undergo a hysterectomy in order to treat their uterine fibroids, but brave women like Ms. Williams are showing the rest of us that that is not the case. Pregnancy is possible, even after fibroids. As long as women know their options and make their voices heard, uterine fibroids do not have to mean the end of their fertility! Thank you to Porsha and to all our other brave #WCWs for making their voices heard and giving fellow women the power of information. 

Will Fibroids Make me Infertile?

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For women who haven’t completed their families, a fibroid diagnosis can be scary: one of the first questions we often hear from patients is, “Can I still have a baby if I have fibroid tumors?”  Fibroid Treatment After Pregnancy

The answer is, unfortunately, not completely clear cut. Without treatment, some women will still be able to get pregnant, but many women will have trouble conceiving without some kind of fibroid treatment. If fibroids stay small, or develop in places where fertility isn’t affected, becoming pregnant may not be a problem. If, however, the fibroids become very large, they may physically block your egg from joining up with male sperm. Even if the sperm and egg are able to join together, a large fibroid could stop the new embryo from becoming implanted in your uterine lining. And, even if an embryo does implant, an untreated tumor can negatively impact the health and growth of a developing fetus. 

So, that’s the bad news…at least part of it. Fibroids can also affect women’s fertility in other, less obvious, ways: 

  • Some fibroids may change the shape of your cervix, limiting the number of sperm that are able to enter your uterus. 
  • Fibroids can also change the shape of your uterus, potentially decreasing the number of places in which an embryo can successfully implant. 
  • Fibroids can weaken the lining of the uterine cavity. They can also decrease the amount of blood reaching a growing fetus. Both of these issues can cause a pregnant woman to miscarry.

Fibroids Don’t Have to End Your Fertility Journey

With all the tolls fibroids can take on your reproductive system, there is still good news: many women who have been diagnosed with fibroids go on to have one or more children. While many women used to automatically undergo hysterectomy (complete removal of the uterus) after learning they had fibroids, these days there are many fertility-preserving options. 

Many women who plan on having children will choose to have a myomectomy (surgically remove the uterine fibroid.) Other women will choose to have a less invasive procedure, like Uterine Fibroid Embolization (UFE), that shrinks their fibroids by permanently cutting off the non-cancerous tumor’s blood supply. Although the research is not conclusive, many women who have UFE have been able to move on and complete their families in the way they want. 

A fibroid diagnosis can certainly be scary, especially if you aren’t done having children, but in this case, knowledge really is power. Getting informed about all your options and choosing the best solution for your family will go a long way towards keeping fibroids from derailing your reproductive plans. 

#WCW: Kandi Buress on Fertility and Fibroids

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Today, Bravo TV star Kandi Buress is reportedly pregnant with her third child, but just three years ago she came forward to talk about how fibroids had taken a major toll on her fertility. In 2015, the then 38-year-old had been trying for two years, unsuccessfully, to have a second child. When she and husband Todd Tucker finally decided to turn to IVF for help conceiving, the couple discovered what was at the heart of their fertility problem: Kandi had a uterine fibroid. 

Getting Candid
“We realized I had a fibroid—a big one—inside the cavity of the uterus where your baby would implant,” the reality star has said. Like Kandi, many women with uterine fibroids experience difficulties becoming pregnant but, luckily for Kandi, her story had a happy ending, one she chose to share with fans in order to give other women hope. 

“Luckily for us, it was a blessing, and we actually had success with the first IVF treatment,” said Burruss. “It takes a couple of months for you to go through the whole process of injections, retrieving the eggs and all of that stuff, then allowing them to put them back in and praying that they take. One of our eggs took.”

Recovery and Conception
Of course, some women cannot conceive that easily with fibroids, and they must treat the tumors before they can become pregnant. Many fibroid suffers think surgery is the only option if they want to preserve fertility, but that’s not actually true! In our Houston Fibroid office, we offer a non-surgical, minimally invasive treatment known as Uterine Fibroid Embolization. Women who undergo UFE experience permanent shrinking of their existing tumors–and pregnancy is still a possibility afterwards! 

There have been reports of many successful pregnancies in patients after UFE. Many studies show that fertility rates and miscarriage rates in UFE patients are no different than patients of the same age with fibroids who have had no treatment. The fact still remains, however, that patients hoping to get pregnant may prefer to undergo a myomectomy (surgical fibroid removal) if they are healthy enough to withstand surgery because some studies have shown that pregnancy complications may be slightly more common after UFE compared with myomectomy. 

The important thing to remember in all this is that a fibroid diagnosis does not mean the end of your dream to carry a child. Like Kandi Buress and many other women, your path to fertility can be successful. It’s simply a question of knowing your options and making the informed decision that’s best for your body and your family. 

#WCW: Gabrielle Union, Fertility Warrior!

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Welcome back to Woman Crush Wednesday! This week we’re celebrating Gabrielle Union, who’s opening up about adenomyosis, a condition that threatens the fertility of many women around the world.  

Gabrielle’s journey began when she and husband Dwayne Wade (of the NBA’s Miami Heat) decided to start a family. Unable to conceive on their own, Gabrielle says she turned to many unsuccessful rounds of IVF to try and become pregnant. Instead of getting support from her doctors, however, the star says she was basically blamed for her own infertility: “Everyone had just sort of chalked it up to ‘You’re a career woman, you’ve prioritized your career, you waited too long and now you’re just too old to have a kid,'” she said. “And that’s on you for wanting a career.”

Fortunately, Gabrielle did not stop looking for answers and, soon enough, she and her doctors discovered the truth: she had adenomyosis, a type of endometriosis that can cause infertility. 

According to Gabrielle, who now wants to raise infertility awareness among women of all ages, she’s had the condition since she was in her 20s. Adenomyosis occurs when uterine lining tissue is found in the muscle layers surrounding the uterus. It is sometimes hard to diagnose because the misplaced tissue acts like other uterine tissue, shedding itself at the end of a woman’s menstrual cycle. Many women have no symptoms, though some experience cramping, pelvic pain and unusual spotting. 

Any woman who has had uterine surgery, including fibroid removals and/or a cesarean section, is at risk for developing adenomyosis; women between the ages of 40 and 50 make up 80 percent of diagnosed cases, so age also appears to be a risk factor. 

Complications like Gabrielle Union’s are just one reason our doctors encourage early, non-invasive treatment options for uterine fibroids. After all, as Ms. Union is now telling fans as she relates her story of struggle, “Fertility is not an older women issue, it is an issue period.”