And DefinitionsFibroids InfertilityFibroid Fibroids are benign (ie noncancerous) of the uterus. They are also called uterine leiomyomata or simply myoma. They grow in the muscle cells of the uterus and may protrude from the surface inside or outside the uterus, or may be contained within the muscle wall.Submucous fibroid fibroid grows beneath the lining.Intracavitary fibroid uterine fibroid, which grows in the womb cavity.Intramural fibroid fibroid which grows in the muscular wall of uterus.Subserosal fibroid fibroid which grows primarily in the area just outside the uterus.Pedunculated fibroid fibroid that is attached to the uterus by a thin stalk.Fibroids are very common. About 25 percent of women of childbearing age who have signs of fibroids can be detected by a pelvic exam, though not all of fibroidsAlthough experience symptoms.Cause exact cause is unknown, the growth of fibroids appears to be related to a gene that controls cell growth. When this gene is functioning normally, cells grow normally. When the gene does not function, cells grow and divide at an accelerated pace. Thus, one cell becomes two, two becomes four, etc. until finally a mass of these cells or fibroid is detected. Fibroid growth is affected by estrogen and progesterone, reproductive hormones. When these hormone levels decrease with menopause, many of the symptoms of fibroids begin to disappear. However, it is clear that hormones actually cause the fibroids to occur. For example, women who had high levels of both hormones, as a result of pregnancy or birth control pills have a lower incidence of fibroids later in life.Abnormalities in blood vessels around the uterus may play a role in the development of fibroids. Changes in chemicals in the body that causes tissue to grow can also be a risk factors involved.Fibroid number of factors that influence the risk of developing fibroids. These include: number of pregnancies of women with one or more pregnancies that extended beyond 5 months have a lower risk of fibroid formation.Use using birth control pills birth control pills can generally protect against fibroids, but the Using the pill at an early age (between 13 and 16) may be associated with increased risk.Smoking Women who smoke appear to have a lower risk of having fibroids. This may be due to estrogenlowering effect if smoking.Diet Eating large amounts of red meat is associated with increased risk, and green vegetable consumption decreases the risk. However, no study has shown that changes in diet lead directly to changes in the incidence or symptoms of fibroids fibroids.Ethnic fund are 2 to 3 times more common in African American women than Caucasians. Among women undergoing hysterectomy (uterus), black women are significantly more likely to have fibroids, to be younger at the time of diagnosis and hysterectomy, and have more severe problems associated with fibroids that most of its white symptomsThe counterparts.Fibroid fibroids are small and cause no symptoms at all. However, many women have significant problems that interfere with some aspect of their lives and want to be treated. The symptoms are related to the number, size and location of fibroids, and are divided into four main groups: bleedingFibroids uterus can cause increased menstrual bleeding is heavier, or increase the duration of bleeding or bleeding between periods can cause . Some women may have a combination of bleeding symptoms. The presence and extent of uterine bleeding is determined mainly by the location of the fibroid. Women with fibroids that protrude into the uterus are more likely to have a significant increase in pressure bleeding.Pelvic and painFibroids may vary in size from microscopic size of a basketball or even more. Larger fibroids can cause a feeling of pressure and fullness in the abdomen, similar to that caused by pregnancy. Fibroids of variable sizes can cause other symptoms depending on where they are. For example, if the fibroid is pressing on the bladder, frequent urination may occur. A fibroid that pushes into the rectum can cause constipation, and that puts pressure on the cervix may result in intercourse.Infertility painful and can cause infertility miscarriageFibroids in a number of different ways. A fibroid can cause compression in the fallopian tubes resulting in a blockage of the sperm or eggs. A large fibroid can distort the pelvic anatomy enough to make it difficult for the fallopian tube to capture an egg at the time of ovulation. If a fibroid protruding into the uterine cavity or causes distortion of the uterine cavity, which can present a mechanical barrier to implantation. Some studies have suggested that fibroids in the uterine muscle may cause an alteration or reduction of blood flow to the uterine lining making it more difficult for an implanted embryo to grow and develop. Another theory suggests that even small fibroids that grow inside the uterine cavity may act as a foreign body and cause inflammation that makes the uterus hostile environment of an embryo implant.Some of these same opportunities that can also increase the risk of embryo abortion. Another possible cause of miscarriage is running out of space as complicationsSome fetus grows.Pregnancy studies have suggested a slightly increased risk of certain problems during pregnancy in women with large fibroids, including difficulties with work, breech of fetus, premature rupture of the amniotic membrane, and placental abruption (a condition where the placenta separates from the uterine wall during pregnancy). These problems are more likely if the placenta is implanted in the area of large fibroids. However, many women with fibroids have completely normal pregnancies and births of healthy babies without complications.Fibroid diagnosisLarger fibroids, especially those who stand outside the uterus can be felt during a routine pelvic examination. However, in an infertility center, most fibroids are detected by ultrasound. Ultrasound can detect much smaller fibroids that can be appreciated by a pelvic exam. This is especially true if a woman is overweight. One limitation of ultrasound is often impossible to determine whether small fibroids in the uterine cavity or fibroids in the uterine muscle wall to bulge or distort the uterine cavity.HysterosonogramThis is an excellent test to determine the relationship of fibroids in the uterine cavity. First, saline (salt water) is slightly instilled into the uterine cavity. This separates the walls of the uterine cavity, enough to enable ultrasound to detect abnormalities in the cavity. A sample of the fibroid as an area where the saline should flow around it. Hysterosonogram also allows measurement of the distance of a fibroid in the uterus cavity.HysterosalpingogramSimilar to ahysterosonogram, thehysterosalpingogramuses light tint that appears on the radiograph to separate the walls of the uterine cavity. Thehysterosalpingogramhas an additional advantage of being able to determine if the fallopian tubes are blocked.HysteroscopyInsertion a fiber optic telescope through the vagina and cervix into the uterus can detect fibroids that are inside the uterine cavity or cause major distortions of cavity. Hysteroscopy can detect fibroids in the uterine muscle wall unless they cause ditrotion of the cavity. It is also able to identify, even large fibroids that are outside of the wall of the resonance uterus.MRIMagnetic uses high powered magnets to determine the difference between different tissue types. It's great to tell the difference between the fibroid tissue and normal uterine tissue. It also serves to distinguish the difference between fibroids and other less common problem known as adenomyosis.SurgeryOccasionally uterine fibroids are detected during abdominal surgery such as laparoscopy. This is useful for fibroids cause distortion of the outer contour of the uterus or that are only attached to the uterus by a thin stalk.Fibroid treatmentIf no symptoms, treatment is usually not necessary. In women with significant symptoms, treatment may be medical or surgical.Medical treatmentMedications called gonadotropinreleasing hormone (GnRH) analogues (Lupron) are commonly used in medical treatment of fibroids. Generally only given as a temporary measure, and during the time a woman is preparing for surgery to remove fibroids. GnRH analogues causes a reduction in estrogen levels. Most women taking these drugs have a cessation of menstruation. The lack of periods may help women with anemia due to fibroidrelated bleeding or prolonged menstrual bleeding to develop your blood counts before surgery. En algunos casos, an�logos de la GnRH puede causar disminuci�n de los fibromas que pueden permitir que se saquen a trav�s de una incisi�n m�s peque�a. Fibroids rapidly expand again after the medication is discontinued. Because there are adverse effects of prolonged low levels of estrogen, GnRH analogues are only temporary treatmentThe measure.Surgical type of surgery you need depends on the size, number and location of fibroids. In addition, the underlying problem is important. Obviously, a woman with infertility, which wants to keep her uterus would be treated differently than a perimenopausal woman is done with motherhood. The procedures performed by women to maintain reproductive capacity or fertility improvement include: abdominal myomectomy Myomectomy means removal of a fibroid. In an abdominal myomectomy, an incision through the abdomen to expose the uterus and the fibroids are removed from the muscles of the uterus. This approach is best suited for women who wish to maintain childbearing, and have multiple fibroids or myomectomy fibroids.Laparoscopic large in this procedure, fibroids are removed through laparoscopy. With laparoscopy, a fiber optic telescope inserted through a small incision at or below the navel, through which the surgeon can visualize the uterus. Additional small incisions are used to enter the longthin operating instruments that can be manipulated to remove the fibroids and uterus after repair. Laparoscopy is most appropriate for women with one or two small to moderate fibroids found in the outer surface of myomectomy uterus.Hysteroscopic As in the case of diagnosis of fibroids, hysteroscopy involves placing a fiber optic telescope through the vagina and cervix into the uterine cavity. Long and narrow surgical instruments can be introduced into the uterus using an operating channel in the hysteroscope. Saline solution is used to keep the uterine walls separated. This procedure can only be done in fibroids mostly located in the uterus cavity.Uterine embolizationUterine artery embolization (UAE or UFE) is performed by a radiologist. Using xray, a catheter is inserted through blood vessels to the uterus. Small spheres are injected into the blood vessels that feed fibroids that cause the blood supply to be blocked. Without a blood supply, the fibroid begins to malfunction. This technique is relatively new. There are few data on the potential risks that may cause a woman who subsequently becomes pregnant.Recently, a Dutch multicenter study examined the effect of uterine artery embolization on ovarian function. The doctors in the study measured a hormone (antimullerian hormone or AMH), which is correalted with ovarian reserve. Women who had had the United Arab Emirates decreased much faster than AMH have been expected. This suggests that embolization thatuterine can cause damage to the ovaries and reduce the number of eggs left in the ovaries.In 2008, the results were published in the Fibroid Registry for outcomes data (fibroid) for embolization uterus. The study was a followup 3 years fibroma of over 2000 women who had uterine artery embolization. This study showed that nearly a third of women who underwent this procedure has to have full term presumably due to lack of blood supply to ovaries.Some studies have identified an increase in some complications of pregnancy after United Arab Emirates. For this reason, this procedure is not recommended for women who want children to keep potential.Surgical Complications Serious complications are rare but may include bleeding, infection, damage to other body structures, problems with anesthesia or even death. Some fear that if the damage is extensive uterus that a hysterectomy may be necessary. Complication.About This would be a rare 11 to 26 percent of women who have myomectomy will require a second surgery. Moreover, laparoscopic and abdominal myomectomy carry varying degrees of risk of uterine rupture during pregnancy or childbirth. Because of this risk, the surgeon may recommend a cesarean section to controversyThere delivery.Infertility much disagreement among doctors about when myomectomy for infertility should be performed. Most would agree that fibroids that are inside the uterine cavity or cause major distortions of the cavity must be eliminated. But what about the single fibroid is inside the muscle wall of the uterus, but not project into the cavity or distortion What happens if two fibroids that How about a very large fibroid attached to the uterus only by a narrow stalk The controversy exists because it is very difficult to do studies that show the effect of myomectomy. Much of the data published in the medical literature comparing the number of pregnancies in a group of patients before and after a procedure. However, this does demonstrate that myomectomy is responsible for improving fertility because pregnancy only occurred after the type best surgery.The study focuses on a large group of women with fibroids identical. Half the group would have a myomectomy and another group will have a simulated surgery where no fibroid was removed. Obviously, this type of study could not do what the controversy is likely to continue for some time. br br
