Latest Fibroid Treatment Techniques Can Preserve Fertility

Uterine fibroids, or uterine myomas, are non-cancerous tumors that can affect women of all ages. While many women with fibroids don’t have symptoms, fibroids can cause long and heavy periods, pelvic pain, pressure on the bladder and rectum, and painful intercourse. Though fibroids don’t always affect a woman’s ability to conceive and carry a healthy pregnancy, in some cases fibroids can cause infertility or increase the chance of pregnancy loss or other complications.

Thankfully, there are treatments available to improve quality of life for women with uterine fibroids. Though hysterectomy, or surgery to remove the uterus, has long been the gold standard in effective treatment, there are many options to treat fibroids that preserve the uterus and a woman’s fertility, says University Hospitals minimally invasive gynecologic surgeon and pelvic pain specialist Douglas Sherlock, MD.

The fibroid treatment option that a woman ultimately chooses may be based on several factors, including her age, whether she wants to have children, and the severity of the fibroids.

“Understanding options allows patients to help them make the right choice for them,” says Dr. Sherlock.

Alternatives to Hysterectomy for Fibroid Treatment

Surgery to remove the uterus or watchful waiting until after menopause have been the traditional options to treat fibroids. However, another surgical option is to remove the fibroids through a procedure known as myomectomy.

In contrast to a hysterectomy, the uterus remains intact in a myomectomy, preserving the woman’s fertility. A myomectomy can be done as a traditional open procedure or can use minimally invasive, laparoscopic techniques.

“Many women want to keep their uterus and may just want a laparoscopic myomectomy to remove the fibroid itself," explains Dr. Sherlock.

This minimally invasive approach also has the benefit of reduced risk of complications, smaller incisions, less postoperative pain and easier recovery.

Additional Treatment Options

As alternatives to hysterectomy, watchful waiting and myomectomy, other treatment options for fibroids include:

Medications: Various medications can regulate hormones and treat symptoms such as heavy menstrual bleeding, and some are able to shrink the fibroids. Medications include gonadotropin-releasing hormone (GnRH) agonists, progestin-releasing intrauterine device (IUD), oral contraceptives, tranexamic acid for heavy periods, and nonsteroidal anti-inflammatory drugs (NSAIDs) for fibroid-related pain.

MRI-guided focused ultrasound surgery (FUS): This therapy uses magnetic resonance imaging (MRI) to locate fibroids, then uses ultrasound to heat and destroy fibroid tissue. This non-invasive option has quick recovery time and low risk for complications. It also preserves a woman’s fertility if she wishes to have children in the future.

Radiofrequency ablation: This minimally invasive procedure uses radiofrequency (heat) energy to destroy uterine fibroids, and can be done either laparoscopically through small incisions in the abdomen or transcervically (through the cervix). The fibroids will continue to shrink over several months following the procedure. Recovery from this procedure is relatively quick, and most women can resume regular activities in about a week.

Uterine artery embolization: With this technique, small particles are injected into the arteries that supply blood to the fibroids, cutting off blood flow and causing the fibroids to shrink. There is a small risk that blood flow to the ovaries and other organs will be affected, but the risk is similar to other surgical treatments for fibroids. Because it also carries a risk of causing pregnancy complications, this procedure is not recommended for women who wish to become pregnant in the future.

Dr. Sherlock says you should talk to your healthcare provider about all the available options for fibroid treatment to help you make a decision that is best for you.

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The women’s health experts at University Hospitals provide compassionate care for women of all ages, providing diagnosis and surgical and non-surgical treatment for fibroids and other gynecologic conditions.