If I find uterine fibroids while preparing for pregnancy, do I need surgery?

If you are not considering pregnancy and having a baby, usually only those fibroids with special locations, causing symptoms such as heavy menstrual flow and anemia, or with a diameter of more than 5mm will require surgery. For women who are preparing to become pregnant, the indications for surgery are different.

1. Consider the situation of pregnancy first

At present, there is no clear standard for the size of fibroids that can be operated on. Some medical institutions believe that if the diameter of the uterine fibroids does not exceed 4 cm and they are intramural or subserosal fibroids, the patient can consider pregnancy. However, it should be noted that fibroids may grow rapidly during pregnancy, causing miscarriage or premature birth.

Note: According to the location of the fibroids, uterine fibroids can be divided into submucosal fibroids, intramural fibroids, and subserosal fibroids.

2. It is best to have surgery first

For submucosal fibroids located in the uterine cavity, since they may hinder the implantation of the fertilized egg and thus cause miscarriage, even if there are no symptoms (usually there are symptoms of menorrhagia or prolonged menstruation), surgical treatment before pregnancy is recommended. It is currently believed that submucosal fibroids are best treated through hysteroscopy.

In addition, if the fibroid is located at the lower end of the uterus (such as the cervix), even if the diameter is less than 4 cm, but the patient has a history of infertility or multiple spontaneous abortions, and no other clear cause can be found, it is also possible to have the uterine fibroid removed first and then get pregnant.

3. How long after the operation can I get pregnant?

This question cannot be answered before surgery. It needs to be judged based on the situation of the surgery:

Special subserosal fibroids (with a slender pedicle connected to the uterus). If the operation goes smoothly and there is almost no damage to the integrity of the uterine wall, pregnancy can be achieved by taking contraception 3 months after the operation.

The fibroids are located within the muscle wall or under the serosa, the number is small, the surgery did not significantly damage the uterine wall, and the fibroids did not enter the uterine cavity. Pregnancy can be achieved by taking contraceptive measures for 6 months after the surgery.

If there are many fibroids, many uterine incisions, the operation is particularly difficult, or the uterine cavity is entered, it is recommended to use contraception for at least one year. In some cases, it may even take two years.