Can you please define “recovery” from a hysterectomy more in detail?                 

Recovery from a hysterectomy depends on many factors.  Recovery from abdominal surgery may take somewhat longer than vaginal or laparoscopic surgery, and it appears that leaving in the cervix may decrease recovery time.  Recovery is gradual, so that it is impossible to state an exact recovery time.  Also, becoming active early greatly speeds up recovery. - Paul Indman, M.D.

Since the UAE cuts off blood supply to the fibroids, does this mean that birth control methods can be eliminated? 

The uterine lining is not removed by this procedure which causes it to remain hormonally sensitive.  The UAE procedure does not stop normal menstruation in most women.  A woman should continue to use a method of contraception after the UAE procedure. - Robert Worthington-Kirsch, M.D.

Have any of the women you performed the Uterine Artery Embolization procedure on become pregnant? - Harrisburg, PA  

There are many women who have become pregnant after having UAE. I have had at least a dozen of my patients conceive after the procedure. Their pregnancy outcomes have been similar to those of women the same age in the general population.   

At this time there is little published or presented data about fertility after UAE. The data does suggest that fertility after UAE is similar to that of women who have had other invasive treatments for fibroids. The decision about fibroid treatments in women who want to preserve their fertility is very complex, and needs the input of the patient, a skilled IR, and an experienced Ob/Gyn or fertility specialist. - Robert Worthington-Kirsch, M.D.  (Refer to Pregnancy Research.)

How soon after giving birth is it ok to have a consultation concerning my uterine fibroids (the fibroids are growing)?

During pregnancy fibroid growth or lack of growth varies from individual to individual.  If they grow during pregnancy, they may reduce in the postpartum person.  For that reason, I would suggest that evaluation be delayed until at least 6-8 weeks after delivery to give the uterus and fibroid an opportunity to get over the changes induced by pregnancy.  Many of these fibroids may end up requiring no treatment.  – Francis Hutchins, Jr., M.D.

My husband and I are married for several years and we had been trying to conceive with no success.  Just a week ago I had an ultrasound performed and uterine fibroids were diagnosed.  I don’t understand the terminology on the report.  What does it mean for me to get pregnant?  I am so worried and frustrated.

This is too complex a subject to answer completely in this format.

Fibroids most often have no effect on fertility or pregnancy.  However, women who have them do have an increased risk of infertility as well as complications in pregnancy most notably early delivery.  The most significant finding on your ultrasound is the question of whether you have a fibroid in the cavity of your uterus. This will require further evaluation.

I would suggest that you and your husband consider an evaluation by an infertility specialist to determine what may be preventing you from conceiving.  In addition you can benefit from getting a book on fibroids written for consumers.  I have written one, “The Fibroid Book”, and there are several others available as well.  You need to educate yourself about this disease so that you can participate effectively in your care. – Francis Hutchins, Jr., M.D.

How long should a UAE patient wait before trying to conceive?   - Harrisburg, PA

There really isn’t a good guideline for a waiting period. Nobody knows whether, or how long, a woman should wait after UAE before attempting to become pregnant. I'm aware of two women who became pregnant within a month of their embolizations, and both had normal pregnancies and delivered healthy babies. In general, I suggest that women wait four to six weeks after UAE before attempting to become pregnant. - Robert Worthington-Kirsch, M.D.

NOTE:  Dr. Indman believes that women who are planning pregnancy should not have fibroid embolization until large studies establish the safety of pregnancy after embolization. 

I had a uterine artery embolization on 10/13/05 and just yesterday found out I am now pregnant.  My doctor suggests I terminate my pregnancy.  Is there major risks to my baby because of this procedure?  I was not expecting to be pregnant but here I am. 

The overwhelming majority of women who have had UAE and become pregnant have had uneventful pregnancies.  I feel that it is grossly irresponsible, as well as inappropriate, to recommend that a pregnancy be terminated solely because a woman has had UAE. There is no justification for this suggestion.  You need to find another Gynecologist.

I have had two (2) patients who became pregnant within 10 days of their UAEs.  One did not want to be pregnant and had an abortion. The other now has a perfectly lovely 6 year old.  I am aware of at least one other patient (of one of my colleagues) who became pregnant in the same time frame and also had an uneventful pregnancy. - Robert Worthington-Kirsch, M.D.

I have uterine fibroids.  I don't have fibroid symptoms.  I have been trying to get pregnant for more than two years.

An Reproductive Endocrinologist (Fertility Specialist) may be able to help you. - Robert Worthington-Kirsch, M.D.

I am pregnant (three months) and I have a 7-8 cm uterine fibroid.   Is there any medical treatments or surgical procedures that can be used during my pregnancy to eliminate/shrink the fibroid?

Usually, fibroids (even 8 cm fibroids) do not cause any problems during pregnancy and do not need to be treated.  About 40% of the time, fibroids will grow during pregnancy, but they still almost never cause problems.  Very rarely, fibroids can cause uterine contractions, but usually these go away with bed rest and do not lead to premature delivery.  There are no treatments to shrink them during pregnancy other than surgical removal, which is almost never necessary.  These issues should be discussed fully with her doctor. -  William Parker, M.D.

I had a myomectomy performed and my doctor suggested I should wait three months before trying to become pregnant.  What is the reason for this timeframe? 

We usually ask women to wait three months after myomectomy for the uterus to heal.  This is the amount of time it takes for the incisions in the uterus to heal entirely, based on studies of how the muscle wall looks under the microscope.  The incisions may actually be able to withstand the demands of pregnancy before that, but nobody knows for sure, so this timeframe is used.  – William Parker, M.D.

Can a pedunculated, subserosal fibroid cause discomfort when you are moving around?  Are birth control pills safe to take when you have a fibroid?  Will the fibroid location cause a negative effect on a pregnancy?

Pedunculated, subserosal fibroids can cause discomfort with movement because the fibroid, which is on a stalk, moves around and may pull on the uterus.  You should know that there is no danger of damage to any nerves or other organs in the body.

Birth control pills are safe for most women with fibroids to take. Very rarely, I have seen a fibroid grow when a woman is on the pill, so you should be examined every 3 or 4 months to make sure the fibroid is not growing.

Since the fibroid is outside the uterine cavity (where the embryo implants and the fetus develops) the fibroid should have no effect on getting pregnant.  Again rarely, the fibroid may grow during pregnancy and cause discomfort and very rarely premature contractions that require bed rest.  As always, you should discuss these issues with your doctor regarding your particular situation.  -  William Parker, M.D.

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