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Uterine fibroids, also called fibromyomas, leiomyomas or myomas, are non-cancerous tumours, which can be found in various locations of the uterus, with varying size and severity.
Around 20% of women of reproductive age develop uterine fibroids that can be detected. However, around 70-75% of women may develop fibroids so small that may not be detected .
The reasons why uterine fibroids develop are unclear. Family history however, is a known risk factor for the development of uterine fibroids . Other risk factors include:
Not all women with uterine fibroids present with symptoms. However, symptoms may arise and include:
Uterine fibroids may affect the ability of a woman to conceive depending on their location . This is because fibroids may interfere with the migration of the egg or the sperm and the implantation of the embryo in the endometrium, the lining of the uterus .
Evidence has shown that uterine fibroids are associated with 10% of infertility cases and are the only reason of infertility in 1% to 3% of couples that cannot have children .
Uterine fibroids may also affect the outcome of an IVF procedure. Studies have shown that the chance of a successful IVF is reduced in patients with fibroids when compared to patients with no fibroids [7, 8].
Removal of the fibroids prior to IVF treatment increases the chances of IVF success [9-12] and is usually recommended by the gynecologist before the start of the IVF cycle .
Uterine fibroids may be detected during pregnancy at the first trimester ultrasound with a rate of around 10% .
The presence and severity of symptoms depend on the number of fibroids, their location and size.
The most common symptom is pain in the abdomen, which affects around 15% of pregnant women with uterine fibroids . They are also associated with pregnancy loss and preterm delivery.
Uterine fibroids can be diagnosed with a pelvic examination and a trans-vaginal ultrasound.
Treatment options for uterine fibroids vary and depend on:
Fibroids can be left untreated or removed with laparoscopy or laparotomy. The last but more radical option is the complete removal of the uterus with hysterectomy.
Laparoscopy is a very common procedure and has been used by doctors since 1979 .
During laparoscopy three or four incisions are made, which are really small and leave minimal scarring on the abdomen. Together with a visual aid the doctor locates and removes the fibroids .
The advantages of laparoscopy when compared with laparotomy, which is an open surgery, are the smaller wound size, shorter hospital stay and recovery time .
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