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What are Fibroids?

Fibroids are benign tumors that are made up of fibrous connective tissue and smooth muscle cells. Fibroids are basically non-cancerous growths in the uterus that develop in or around the womb. They are also known as uterine myomas or leiomyomas. These fibroids usually develop during childbearing years of a woman and thus affect woman’s fertility. The reasons for fibroids are still unknown but it is usually due to combination of hormonal, environmental and genetic factors.

Are Fibroids common?

Around 20 to 50% of women of childbearing age have fibroids in their uterus. However they generally affect African-American women. More than 60% of African-American women have this problem and thus may have difficulty in conceiving.

How Fibroids affect fertility?

There are many ways in which fibroids can affect the fertility of a woman.

i) Fibroids can alter the shape of the uterus and cervix which can affect the number and motility of sperms that can enter the uterus.

ii) Furthermore, fibroids can cause the blockage of the fallopian tubes which will prevent fertilization to occur.

iii) Fibroids can also affect the blood flow to the uterine cavity which decreases the ability of an embryo to implant to the uterine wall.

iv) These fibroids can also impact the thickness of the uterine lining which causes infertility among women.

Types of Fibroids

There are three types of fibroids namely:

Subserosal Fibroids

These fibroids are present in the outer wall of the uterus. These fibroids can be easily removed either through an abdominal myomectomy or a laparoscopic approach.

Intramural Fibroids

This type of fibroids grows within the muscle of uterine wall. Intramural fibroids are the most common type of fibroids.

Submucosal Fibroids

Submucosal fibroids develop in the middle muscle layer of the uterus and grow inwards into the uterine cavity.

Can Fibroids be treated?

Fallopian Tube Blockage

Fallopian tubes communicate with the uterus on one end and with the ovary on the other. When the egg is released by the ovary (ovulation), either of the fallopian tube picks up the egg and slowly moves it towards the uterus. Sperms are deposited in the vagina at the time of sexual contact. They swim up through the uterus into the tubes, where if an egg is present, the two meet and fertilization occurs. The fertilized embryo is then transported by the tube slowly over the next five days to the uterus, where if the embryo implants, pregnancy ensues. Functioning fallopian tubes are therefore essential for pregnancy to occur naturally. If both tubes are blocked, the chances of spontaneous conception are very remote.

How do we diagnose fallopian tube block?

Fallopian tube blockage is one of the major reasons of female infertility. Women with blocked tubes do not generally have any symptoms and present with the complaint of inability to conceive. The diagnosis is made by tests for tubal patency like hysterosalpingography (HSG) or sonosalpingography (SSG). A radio-contrast liquid (which is visible on x-ray) is injected in HSG, and water in case of SSG, through the cervix. If the tubes are patent, the liquid fills the uterus followed by the tubes and then seen spilling out of the open end of the tubes. If the result is inconclusive, laparoscopy is the gold standard for diagnosis of fallopian tube block.

How can women with blocked tubes become pregnant?

Blocked tubes cannot be opened by prescribing medicines. It may be possible to open the tubes by surgery in some cases and pregnancy can occur by natural means. Laparoscopic surgery is now preferred to open surgery if the surgeon is trained for laparoscopy. However, not all tubes are amenable to surgery and not all women will conceive even if the tubes become open, as they may not be normal in their function. The alternative to surgery to achieve pregnancy is IVF. In Fact, IVF gives a greater chance of achieving pregnancy than surgery if tubal block is the only reason for infertility.

How can IVF help?

IVF provides the best chance of pregnancy in women with blocked tubes. It is possible because the process of fertilization for which tubes are required is carried out in the laboratory. Additionally, pregnancy rates are higher in IVF than natural conception because it involves overstimulation of ovaries to produce more than one egg, which increases the probability of pregnancy.

In IVF, multiple eggs are removed from the woman’s ovary using a needle guided by ultrasound, under anesthesia and then mixed with her partner’s sperm. The resulting embryos are then kept in the incubator for several days and allowed to divide and grow.

You must be wondering and having a lot of questions regarding your fertility treatment? And it is always good to take steps that are recommended from the doctors. Fertility treatment can go wrong in most of the instances as the success rate of it is bit lower. Thus the question of the next fertility treatment does arise.

There are many fertility treatments today, but the most popular one is in-vitro fertilization or IVF because of its higher success rates as compared to others. While the success rate is high in the, IVF treatment in Delhi there are chances of failures too. Not every couple who go under IVF treatment has a child successfully.

There are also few miscarriages as the success rate of having a child through IVF treatment is only 33 percent. There is however few questions in the mind while going for IVF treatment is that how long the couples should wait between the treatment cycles to get pregnant soon. Recently a study was carried out to check whether waiting for few months between the cycles is helpful or not. But there was no clear evidence to prove the result.

The case of the fertility treatment varies in women and the determination is done as per the ovulation cycle by the best IVF doctor in Delhi NCR. Thus ladies who are having the regulation ovulation, and the problem of the infertility are faced then in this circumstances three months of Clomidin conjunction with intrauterine insemination (IUI) is prescribed.

And in the cases where ovulation is not regular which is commonly known as polycystic ovarian disease (PCOS) three to four cycles of Femara with intrauterine insemination is recommended.

Instead of back to back treatment of IVF, the fresh treatment can be taken after 1 month’s break although an individualistic approach is followed for each couple’s treatment.

There are two school of thoughts related to this where consecutive and alternative months of treatment bear the same results not affecting the implantation and live birth rates. But these factors are even determined on the physical and mental wellness. Thus you always have the chance to choose the time period depending upon your comfort.

Break between IVF treatment cycles

Another study was conducted and according to that break between IVF cycles does not make any difference on the couples. This study makes clear that whether the couples go for consecutive IVF cycles or wait for few months to try again, the success rate will not change.

Study on two different groups