Uterine fibroids (aka myoma or leiomyoma/ta) are common benign tumors that are often found in women wishing to conceive. In some cases, fibroids might reduce the fertility potential of affected women, and a treatment might be needed. A recent narrative review by Pietro Gambadauro discusses the potentially detrimental role of uterine fibroids on female fertility and the possible treatments.
Dealing with uterine fibroids in reproductive medicine
J Obstet Gynaecol 2012;32(3):210-216
Correspondence: P. Gambadauro, Centre for Reproduction, Department of Obstetrics and Gynaecology, Uppsala University Hospital, 75185 Uppsala, Sweden.
Women who wish to conceive are nowadays more likely to present with uterine fibroids, mainly because of the delay in childbearing in our society. The relationship between uterine fibroids and human reproduction is still controversial and counselling patients might sometimes be challenging. This paper is to assist those involved in the management of patients of reproductive age presenting with uterine fibroids. The interference of fibroids on fertility largely depends on their location. Submucous fibroids interfere with fertility and should be removed in infertile patients, regardless of the size or the presence of symptoms. Intramural fibroids distorting the cavity reduce the chances of conception, while investigations on intramural fibroids not distorting the cavity have so far given controversial results. No evidence supports the systematic removal of subserosal fibroids in asymptomatic, infertile patients. Myomectomy is still the ‘gold standard’ in fibroid treatment for fertility-wishing patients. In experienced hands, hysteroscopic myomectomy is minimally invasive, safe, and effective. Abdominal and laparoscopic myomectomy might be challenging, but potential risks could be reduced by new strategies and techniques.
Keywords: Conservative treatment, hysteroscopy, infertility, laparoscopy, leiomyoma, reproduction, uterine fibroids
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Journal of Obstetrics and Gynaecology: Dealing with uterine fibroids in reproductive medicine