Uterine fibroids are benign or non-cancerous growths or tumors, in woman of childbearing age, arising from the muscle of the uterus or myometrium. They are made up of connective tissue that grows within the muscular walls of the uterus. They can grow as a simple fibroid or in clusters. These benign tumors can be as small as an inch in size or can grow to eight or more inches. No one is sure what causes fibroids to develop or stimulates their growth but fibroids can lay dormant for months, or even years then, all of a sudden, double or triple in size. Current statistics shows show that they are 3-5 times more common in African-American women; and, slightly increased in women that are overweight for their height and decreased in women that have given birth. The biggest stimulus to fibroid growth is pregnancy, and thus, could cause problems with implantation of the embryo, placentation or development of the placenta, first and second trimester loss, prematurity, premature rupture of the membranes (bag of water) and a breech presentation.
Fibroids can grow on the outer wall of the uterus or subserosal; in the muscle of the uterus or intramural; or right under the lining of the cavity or submucosal or in the cavity of the uterus, known as intracavitary. The second worst place for fibroids to grow is in the muscle of the uterus (intramural) because they can push into the cavity of the uterus and compromise the blood flow to the baby or push outward and make the uterus think it is bigger than it is and result in premature labor. The worst place for fibroids is in the cavity of the uterus (intracavitary) because that is where the baby grows and results in the biggest risks of complications. Fibroids on the outside of the uterus (subserosal) can generally be a little bigger before they cause problems in having the uterus think that is bigger than it really is and causing premature labor that may or may not be able to be stopped with bed rest, prolonged hospitalization and medications.
Many times, patients are told that their fibroids are not a problem and that they can go on and have a successful pregnancy without problems. Although, that can be true in many cases, in others, fibroids, can and will prevent you from conceiving or increase your risks of a miscarriage. Patients need to know both possibilities, as well as the risks and complications if nothing is done, and all available options. Many couples do not want to take the risks of not getting pregnant or worst, having a premature delivery, where the baby could have a number of complications or lifelong problems.
If surgery is recommended, it should be done by someone who has extensive experience and expertise. If a woman is in the childbearing years and has no children or still wants or is thinking about having more children, than hysterectomy is never an option. Arizona Center for Fertility Studies has a tremendous amount of experience with fibroid surgery, is totally committed to fertility preservation and never discusses the possibility that a hysterectomy maybe needed. As a matter fact, Arizona Center for Fertility Studies, not once, has had to put the option of hysterectomy on the surgical permit. Far too often, this is the option women are given by their doctor. If there are multiple and/or large fibroids, they can be removed successfully and with minimum to no resulting scar tissue. Although, there are other options to shrink fibroids, including the use of lupron and/or uterine artery embolization, both will result in the growth of the fibroids as soon as pregnancy occurs and possibly lead to the abovementioned complications.
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