How long does it take to get pregnant after fibroid removal? Pregnancy after surgery to remove uterine fibroids

Gynecological diseases affect a woman's reproductive function. The most dangerous tumors are those that are removed. Uterine fibroids are pathological neoplasms, the treatment of which often involves surgery. Women of childbearing age are concerned about whether it is possible to get pregnant after removal of uterine fibroids.

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The effect of surgery on reproductive function

Treatment of uterine fibroids can be carried out conservatively, but often the patient is indicated for surgery to eliminate the tumor formation. After removal of fibroids, reproductive function is impaired. But depending on the type of surgery, the problem may be temporary or permanent.

When using gentle treatment methods, only the tumor itself, or part of the organ tissue along with the myomatous node, is removed. In this case, the reproductive organs continue to function normally after restoration. Only when the organ itself (the uterus) is removed is a diagnosis of infertility made. In other cases, the possibility of conception, according to statistics, remains in 85% of women. The remaining 15% include patients with complications.

Hysteroscopy

A modern method of removing myomatous tumors is hysteroscopy. This method is used for diagnostic examinations, as well as for surgical purposes. Hysteroscopy is the least traumatic for the female body.

Hysteroscopy

The advantages of hysteroscopy are the absence of tissue incisions and a long rehabilitation period. In the future, pregnancy after removal of uterine fibroids using this method can occur within two months.

Hysteroscopy is used to diagnose very small tumors located on the surface of tissues inside the organ cavity. Hysteroscopy is not recommended for all patients, as it has multiple contraindications.

Laparoscopy

In most cases, treatment in the presence of fibroids is carried out by laparoscopy. The method is considered quite modern. To perform the operation, the surgeon needs to make three incisions through which the tumor is removed. Used to eliminate formations of small sizes.

Laparoscopic removal of fibroids

Pregnancy after laparoscopy of uterine fibroids is possible. But to restore reproductive functions after laparoscopy, it takes much longer than when using hysteroscopy.

Recovery takes at least six months. In case of complications, the patient needs to undergo additional treatment. Before planning a pregnancy, you should obtain the consent of your doctor.

Myomectomy

In the presence of larger nodes or multiple neoplasms, myomectomy is prescribed. Myomectomy can be performed using two previous methods (hysteroscopy and laparotomy), however, surgical intervention involves a more complex operation.

After myomectomy, the patient can become pregnant, but rehabilitation takes at least a year. This is due to traumatization of the organ tissue, as a result of which during subsequent pregnancy there is a risk of complications (improper position of the fetus, postmaturity, etc.). Myomectomy can also be performed by abdominal surgery.

Cavitary

Abdominal surgery is prescribed in the presence of complications. The abdominal method involves making an incision in the uterus or completely removing it. If the organ is preserved, a woman has a greater chance of becoming pregnant.

Abdominal surgery to remove fibroids

The cavity method is the most traumatic, for this reason it is recommended to plan a pregnancy no earlier than a year later. Before a planned conception, a woman should check the condition of the sutures on the uterus, since the elasticity of the tissue due to the presence of scars is much lower and pregnancy can cause serious complications.

Removal of uterine fibroids, regardless of the method used, is a serious operation that has a direct impact on the condition of the reproductive organs. Under the influence of the disease and subsequent treatment, the functioning of the entire reproductive system is disrupted. It is advisable to plan pregnancy after successful treatment, having previously undergone all the necessary examinations to exclude the pathological course of fetal development and the period of gestation.

Despite the fact that if the outcome of the operation is positive, conception can occur even after two to three months, experts recommend using contraceptives for at least six months. It will take at least a year for the body to fully recover.

Rehabilitation

The method of surgical intervention affects the duration of the rehabilitation period. Rehabilitation after hysteroscopy is much faster. The functionality of the organs is restored within one month. After laparoscopy, complete rehabilitation can last up to two months. As a rule, complications do not arise during the rehabilitation period.

Rehabilitation after abdominal surgery is the most difficult. Tissue injury, suturing and direct damage to the organ lead to pain for a long time. The uterus itself also takes a long time to recover. It takes about ten days for the incision to heal, but complete recovery takes 1 month.

monitor changes in your condition;
periodically undergo ultrasound examinations;
take hormonal medications;
take a course of medications to prevent inflammation and tumor recurrence.

During rehabilitation, the menstrual cycle is also restored, which is very important for conception.

Restoration of the menstrual cycle

Uterine fibroids are often caused by hormonal imbalances. Hormone imbalance also affects the functionality of the ovaries, which are responsible for the menstrual cycle. In the first month after surgery, your period may not come on time. After hysteroscopy and laparoscopy, the cycle should be restored in the second month. During abdominal surgery, menstruation may not be regular for three to six months.

Some patients may not have periods at all in the first four to six weeks. If this interval is prolonged, then you should contact your doctor to identify the causes of the deviation. Possible disruption of ovarian function.

As soon as menstruation becomes regular and all the necessary examinations have been carried out, the woman can plan a pregnancy, but only with the prior consent of the doctor.

Planning a pregnancy

To increase the chances of successful conception, the normal course of pregnancy and the process of childbirth, it is necessary to properly prepare the body for the upcoming changes.

Preparing for pregnancy planning includes undergoing examination:

Ultrasound of the uterus and ovaries;
colcospia;
taking tests.

You should also take medications for prevention:

folic acid;
hormones;
vitamins.

excluding the use of alcohol and tobacco products;
eating mainly natural products;
exclusion of any stressful situations;
limiting physical activity.

If there are no contraindications to conception, you should also monitor the periods of ovulation, during which the chances of getting pregnant are much higher.

Uterine fibroids should not be perceived by a woman as a death sentence. The tumor is benign, so the disease can be completely cured. The most important thing is to start treatment on time to avoid complications.

If the tumor is diagnosed in a timely manner and comprehensive treatment is carried out, after removal of the fibroids, a woman may not worry about the possibility of becoming a mother. When a tumor is detected in patients of childbearing age, doctors strive not only to get rid of the disease, but also to preserve the reproductive organs with the possibility of their full functioning. To prevent radical treatment methods, experts advise the fair sex to regularly visit a gynecologist, at least twice a year.

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Uterine fibroids are one of the most common pathologies in the field of gynecology. Despite its benign nature, this phenomenon can pose a serious danger to a woman’s health, so she needs active therapy, and in more serious cases, surgery is performed to remove the tumor.

When to plan pregnancy after UAE?

It is worth immediately noting that uterine embolization in no way affects the reproductive functions of the female body. This is a procedure that hundreds of women go through every year, and most of them after some time give birth to full-term and completely healthy babies. Fibroids can be removed in many ways, but cases where difficulties have occurred with the subsequent fertilization of an egg in medical practice are very rare.

When can you get pregnant after fibroid removal? It is difficult to give an unambiguous answer, because each patient has her own individual characteristics of the body, which cannot be ignored in this situation. Since bearing a fetus is a very serious matter, it must be approached with responsibility, without neglecting even the most insignificant, at first glance, nuances.

Gynecologists believe that... ...after treatment of the disease, no matter how it is carried out, at least 9 months must pass before a woman decides to get pregnant. During this time, the walls of the uterus will have time to fully recover, and the organ itself will become stronger after the operation, which is extremely stressful for it, as well as for the entire female body.

But sometimes it may take longer for the tissue of the uterine walls to completely regenerate. This occurs if the fibroids were multiple and affected a significant part of the cavity of the reproductive organ. Doctors may recommend delaying pregnancy planning for 12 to 15 months. This is done so that the effectiveness of rehabilitation therapy can be assessed, which consists of taking vitamin complexes and performing certain physical exercises. When the course of treatment is over, you need to see a doctor and undergo an examination.

Under what conditions are fibroids and pregnancy compatible concepts?

The presence of a benign neoplasm in the uterine cavity is not a death sentence, and full gestation is possible if:

The tumor is not located directly on the walls of the reproductive organ.
Myoma is not of critical size, which will not put pressure on the placenta.
The uterus no longer has any other pathologies.

Of course, any nodes, even benign ones, can seriously affect pregnancy, which is why it is necessary to remove them before the woman decides to become pregnant.

What complications does the operation entail?

Pregnancy after tumor removal is impossible in 2 cases:

The nodes located in the uterine cavity prevent the fertilized egg from attaching to its walls.
The neoplasm blocks the path of sperm into the fallopian tubes, as a result of which the seminal fluid cannot reach the egg, and fertilization does not occur.

Many patients are worried about how, and whether it is even possible to get pregnant after removal of uterine fibroids? Doctors are unanimous on this matter: if all favorable conditions are created for fertilization, then you can get pregnant both naturally and with the help of IVF.

However, there are several concomitant pathologies that will adversely affect pregnancy and its outcome:

Endometriosis.
Polycystic ovary syndrome.
Endometrial polyps.

If pregnancy has already occurred, and only then the expectant mother found out about the presence of the disease, then first you need to register with a gynecologist. Only he will be able to decide on the elimination of fibroids, if necessary.

Possible complications after UAE may include:

spontaneous termination of pregnancy (miscarriage);
premature birth;
fetal hypotrophy;
umbilical cord damage;
opening of postpartum hemorrhage;
damage to the placenta;
difficult birth.

It is for these reasons that pregnancy after removal of fibroids should be planned carefully with mandatory consultations with a doctor.

Although removal of a tumor using UAE is considered the safest procedure, it also has its own risks, nuances and contraindications. It can be performed only if there is no likelihood of heavy bleeding. If the patient has poor thrombus formation, then any surgical intervention can lead to the fact that you will not be able to get pregnant, and in some cases, even death.

Childbirth after surgery: cesarean or natural delivery?

Getting pregnant after removal of fibroids, according to doctors, is not a problem, and even those women who are afraid of complications can consider themselves absolutely safe. However, many expectant mothers are concerned about another important question: which birth can be considered safe - natural, or through surgery (by performing a cesarean section)?

Indeed, this is a very important decision for any woman who has had uterine fibroids removed. As a rule, after this manipulation, the patient’s body recovers quite quickly, without requiring additional courses of therapy. But if you still want to play it safe so that your pregnancy proceeds safely and without complications, then before planning it, you can take special vitamins for several months.

If there are no complications after the operation, then you can safely decide to have a natural birth - it will not harm either you or the baby. Caesarean section is used exclusively in extreme cases when multiple nodes were found in the uterine cavity. They can put pressure on the fetus and placenta, which can subsequently lead to disruption of its normal and full functioning.

After tumor removal, a caesarean section is almost never necessary, so women are able to carry and give birth to a baby on their own. Natural childbirth has a positive effect on the complete recovery of the body after surgery, and in some cases even prevents the recurrence of uterine fibroids.

Planning pregnancy with multiple fibroids

When can you get pregnant after surgery to remove uterine fibroids? Only a doctor can give you the answer to this question. But in any case, planning a pregnancy after surgery to remove uterine fibroids must take into account the severity of the disease, as well as the condition of the expectant mother after UAE. To do this you need to undergo a full medical examination.

However, there are cases when the consequences of an advanced disease are truly catastrophic and during the operation not only multiple fibroids are removed, but also the uterus itself. This happens if you do not pay attention to the alarming symptoms in time and do not start therapy.

In this case, the woman will never be able to get pregnant. Therefore, it is better not to delay a visit to the gynecologist when at least some suspicions arise. After removing all tumors, a long period of time must pass, during which the wounds in the uterine cavity will completely heal and the vessels will restore normal blood circulation in the reproductive organ.

Before you decide to get pregnant, you need to make sure that your body is completely ready for this. To do this, it is necessary to take into account important factors that can affect both the course of pregnancy and the subsequent process of childbirth:

size of postoperative scars;
age of the expectant mother;
if the patient has already given birth, then the course of the previous pregnancy must also be taken into account.

These points do not mean at all... ...that a woman is at risk, but in order to avoid unpleasant consequences, you need to remember them.

It is important for women not to forget that it is possible to become pregnant after removal of the uterus, only during this period you must follow all the recommendations of the gynecologist. Uterine fibroids are treated both using gentle methods (tablets, vitamins and other medications) and through surgery. And pregnancy after removal of uterine fibroids does not threaten serious complications, especially if the expectant mother takes care of her health in advance and creates favorable conditions for the full intrauterine development of her unborn child!

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Possible complications of pregnancy after removal of uterine fibroids

Some pathologies of the pelvic organs can negatively affect the reproductive function of the expectant mother, in particular myomatous tumors. How does pregnancy proceed after fibroid removal, and why can complications arise?

What types of surgical intervention are used?

When uterine fibroids cannot be eliminated with drug therapy, the tumor can be removed by a doctor through surgery. This is done through hysteroscopic, laparoscopic methods, vascular embolization, and conventional abdominal surgery. Each of these methods has its own characteristics and impact on the reproductive function of women.

Hysteroscopy is one of the safest ways to remove uterine fibroids for a woman who wants to have a child in the future. The doctor does not make any incisions; penetration into the uterus is carried out through the vagina.

Removal can be done electrically, laser or mechanically without opening the uterine cavity. The operation takes about 15 minutes, does not leave scars on the uterus, and patients recover fairly quickly.

Laparoscopy is also safe for expectant mothers, as it allows you to preserve full reproductive function. After therapy, a woman is rehabilitated in a short time, and after about six months she has the opportunity to plan the birth of a child.

Another method used to remove uterine fibroids is embolization of blood vessels that provide nutrition to the reproductive organ. With this treatment, the vessels feeding the tumor are blocked, as a result of which the tumor gradually decreases and eventually dies. This method is the most harmless for women planning a pregnancy in the future.

In some cases, patients have to agree to abdominal surgery to remove uterine fibroids. This can only be done in particularly severe cases. After such a surgical intervention, the reproductive organ acquires scars, and the menstrual cycle fails.

The patient needs quite a long time to fully rehabilitate. Pregnancy after a myomectomy of this type is possible no earlier than a year later. The probability of conception is very high, but bearing a child may be complicated, since there are scars on the uterus.

Is it possible to get pregnant after therapy?

Is it possible to get pregnant after fibroid removal? Thanks to modern medical techniques, it has become possible to preserve reproductive function in women. The main thing is that in the future after the operation there are no complications that would prevent the conception and bearing of the baby.

After surgery, the following risks are possible:

The formation of adhesions that can prevent a woman from bearing a child normally.
Re-development of uterine fibroids. No operation can guarantee that the pathology will not reappear after some time. This does not happen very often, but it is still a possibility. This can make it difficult to conceive and carry a baby.
The appearance of scars on the walls of the uterus and bleeding. Scars may form during abdominal surgery. This ultimately leads to the development of ectopic pregnancy after removal of fibroids, spontaneous abortion.

The most important and dangerous sign for a future pregnancy after fibroids is the formation of scars.

The prognosis regarding the favorableness of bearing a child is based on how many such injuries are on the uterus, whether the reproductive organ itself was opened, and whether a scar can grow before the baby is born. All these factors determine whether a woman carries a child after surgery or not.

Diseases of the placenta

If a woman has a scar on the wall of the uterus after surgery, then a serious obstacle to the normal attachment of the placenta is created. The fertilized egg cannot find the most favorable place for itself, so it has to attach itself in a not very convenient place.

If the fertilized egg chooses a place on the lower region of the genital organ, then the woman experiences complete placenta previa, and also increases the likelihood that bleeding will bother her during pregnancy. With this diagnosis, a pregnant woman will not be able to give birth on her own, so a caesarean section is prescribed.

If the placenta is located directly along the uterine scar, then placental insufficiency occurs. As a result, the blood circulation of the reproductive organ is disrupted, thereby deteriorating the activity of the fetal place. This leads to the fact that the baby does not receive enough nutrients and oxygen.

When the fetus does not fully provide oxygen, disturbances in the intrauterine development of the child’s brain occur. And if the baby does not receive the necessary vitamins, then the physical development of the baby may be delayed. After the baby is born, various malfunctions in the child’s body are guaranteed.

The occurrence of uterine rupture

Another rather dangerous condition for a woman when pregnancy occurs after removal of uterine fibroids is rupture of the organ in the place where the scar runs. This can happen both during gestation and during labor.

The uterus can rupture due to the fact that the scar is very weak and cannot withstand strong stretching. When a pregnancy rupture approaches after laparoscopy of fibroids, a woman will feel the following symptoms:

Nausea and vomiting.
Pain in the abdomen, radiating to other areas of the body.
Overstrain of the muscles of the reproductive organ.
Bloody discharge from the vagina.

If a uterine rupture has already occurred, then such signs as:

Rapid deterioration of the woman's general condition.
Dizziness.
Low blood pressure.
Increased heart rate.
Shortness of breath.
Pale skin.

When the uterus ruptures, a lot of blood comes out into the abdominal cavity, fetal hypoxia occurs, and the baby’s condition worsens. In this case, immediate medical attention is important.

If the uterus begins to rupture directly during labor, then the following manifestations are noticeable:

Nausea, vomiting.
Pain syndrome.
Weakness.
Increased pain during contractions.
Poor progress of the baby, despite the full dilation of the cervix.

There is also increased tension in the muscles of the uterus and the appearance of blood discharge from the vagina. Rupture of the reproductive organ occurs almost immediately after the onset of these symptoms. Therefore, it is necessary to provide emergency medical care, otherwise the pregnant woman and baby may die.

How is a repeat pregnancy planned and managed?

After how long you can get pregnant, the attending physician decides. Before conceiving, you should definitely check your body well so that in the future there will be no problems with pregnancy and childbirth.

If a woman becomes pregnant, she must register as early as possible, no later than 12 weeks. During the pregnancy process, it is necessary to undergo an examination. Ultrasound examination is considered one of the most important.

It allows you to identify signs of scar failure on the wall of the uterus, namely, determine whether its contours are intermittent, whether the muscles of the reproductive organ are thinned, or whether there are particles of connective tissue in the scar.

If an incompetent uterine scar is detected, the woman will not be allowed to give birth on her own. In this case, only a caesarean section is indicated. Otherwise, natural childbirth after myomectomy can cause rupture of this lesion, bleeding, death of the laboring woman and the child itself.

If a full-fledged scar is detected, the doctor may allow you to give birth on your own, but only under the following conditions:

Head presentation of the fetus.
The same size of the baby's head and the pelvic part of the pregnant woman.
Finding the placenta outside the scar.
No negative consequences of bearing a child.

In the case when uterine myomectomy is carried out directly during pregnancy, the woman will give birth exclusively by cesarean section. If during the process of natural childbirth with a full-fledged scar, complications suddenly arise or the baby’s condition worsens, then emergency care is provided through a cesarean section.

Rehabilitation period

In order for a woman to fully recover and think about future offspring, she needs to follow certain rules after laparoscopy of uterine fibroids or other operations. The patient must take medications prescribed by the doctor.

At home, it is important to monitor your health; overwork, hypothermia, lifting heavy loads, or staying in a sauna, bathhouse or on the beach for a long time should not be allowed. You need to spend more time outdoors and eat right.

Thus, it is possible to conceive and give birth to a child after removal of even large fibroids. But this depends on many factors, so each case is individual. When you can conceive a child, only your attending physician can say more precisely.

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Uterine fibroids during pregnancy

Quite often, women of reproductive age have questions regarding the possibility of pregnancy with uterine fibroids or after surgery to remove them. It is very important to make the right decision regarding the management tactics of each individual patient. Are uterine fibroids and pregnancy compatible?

Myoma is a benign tumor consisting of muscle tissue.

Occurs when the muscle cells of the uterus actively begin to divide. Doctors have not fully figured out why this happens, but the most likely reason is hormonal stimulation and increased secretion of estrogen. Return to content

Is it possible to get pregnant with uterine fibroids?

The answer to this question depends on many factors that should be taken into account:

Localization of myomatous node

If the myomatous node is localized in the cavity or wall of the uterus in such a way that the cavity is deformed, or on the cervix, then pregnancy is physiologically impossible. Nodes of this arrangement act as a spiral and are a kind of contraceptives. Sperm simply remain on the surface of these nodes and do not reach the fallopian tubes. Therefore, the egg and sperm do not meet. Such nodes should be removed!

If the myomatous nodes are small in size and located in the wall of the uterus itself or outside (subserous localization), in the absence of deformation of the cavity, pregnancy can occur under other satisfactory conditions. In the case of the described nodes, it is possible to plan a pregnancy. In the future, problems are still possible; they may be associated with pregnancy, but their frequency, according to statistics, is about 15-20%.

If there is a node with a thin stalk, there is a risk of torsion during pregnancy, which will lead to emergency surgery and possible termination. If you are preparing to become a mother, such nodes should be removed first.

If, according to the results of ultrasound and observations, the fibroid is growing rapidly, i.e. increases in size by 1.5-2 times within six months, then planning a pregnancy with uterine fibroids is impossible. In this case, there is a high risk of fibroid growth during pregnancy, there is a possibility of disturbances in the nutrition of the myomatous node, and the risk of miscarriage increases. In this case, it is necessary to undergo preliminary surgical treatment.

If the fibroids are large (the size of the uterus exceeds 10-12 weeks of pregnancy, and in the case of IVF in the presence of fibroids is more than 4 cm), you should not plan a pregnancy, there is a high probability of miscarriage and malnutrition during gestation, which can lead to emergency surgery . And pregnancy in this case is unlikely, because In 60-70% of such patients, endometrial pathology occurs, which makes embryo implantation impossible.

Do uterine fibroids grow during pregnancy? It is not possible to predict the “behavior” of fibroids during this period. This is a genetically determined factor. According to statistics, 65-75% of nodes decrease by about 30%, but 25-35% of fibroids during pregnancy can grow, very rapidly, and, as a rule, the increase occurs by 100%.

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How to remove fibroids during pregnancy planning?

The question of the method of surgical intervention in the case of uterine fibroids is quite complicated. Laparoscopy, on the one hand, has more advantages, the main one being a reduction in the likelihood of developing an adhesive process in the pelvis. Subsequently, this will help maintain patency in the fallopian tubes, which is an important factor in the fertilization of the egg. With laparotomy, the likelihood of the formation of adhesions is noticeably higher, and their appearance becomes possible both in the pelvis and in the abdominal cavity. In the future, this will lead, in addition to infertility, to complications in the gastrointestinal tract.

However, on the other hand, it is believed that in the case of large fibroids, during laparoscopy it is not always possible to sutured the uterus in the required way. This is associated with laparoscopic technique.

The quality of healing of the suture on the uterus may vary from patient to patient and depends on several factors:

Features of the body
Quality of the scar when suturing the uterus (scar formation, correct matching, layered suturing)

So, the most optimal (maximum) size of the nodes for possible laparoscopy for a patient planning to become pregnant is 5-6 cm. For suturing in this case, the special skill of the surgeon is required. In the case of large nodules, new technologies have already been developed for suturing the uterus, which make it possible to strengthen its walls, but the likelihood of a risk of uterine rupture along the scar in this case is always higher.

In the presence of nodes larger than 9-10 cm, the risk of rupture along the scar is higher than the risk of formation of adhesions after laparotomy. Here, surgeons, as a rule, refuse laparoscopy and perform transsection, taking into account the reproductive wishes of the woman.

The incidence of adhesions after laparoscopy is significantly lower than during transection (laparotomy). But with large myomatous nodes, endometriosis and inflammation of the appendages, genetic characteristics in the postoperative period, there is a risk of re-development of the adhesive process. According to statistics, the likelihood of the formation of adhesions is higher when the myomatous node is localized in the uterus on the back wall. The reasons for this fact are currently unclear.

If there are concomitant pathologies (chlamydia, endometriosis, gonorrhea, etc.) in patients who are interested in pregnancy, a control laparoscopy is performed after about 6-8 months to assess the condition of the fallopian tubes. The issue of reoperation is always decided individually, taking into account many factors and individual characteristics.

After laparotomy for removal of large fibroids, due to the high likelihood of adhesions forming, control laparoscopy is performed in most cases to restore patency of the fallopian tubes.

Return to content

When can you get pregnant after surgery?

After surgery to remove fibroids, regardless of the method (laparotomy or laparoscopy), you can become pregnant after 8-12 months, this depends in most cases on the size of the removed node. With small sizes (3-4 cm), you can plan a pregnancy after eight months. Such restrictions are associated with the physiological characteristics of the recovery of the uterine muscles. On average, the resorption of sutures is completely completed only after 90 days from the date of surgery. Considering that the size of the uterus increases significantly during pregnancy, the muscles stretch and hypertrophy very much, it is necessary for the scar to heal fully.

Indications for cesarean section after such an operation are determined individually each time and depend on the size of the fibroid that was removed, because this affects the size of the scar, from its previous location, from concomitant indications (age of the pregnant woman, duration of infertility treatment, presence of preeclampsia), from ultrasound data of the suture during pregnancy.

In general, if fibroids are removed up to 3-4 cm, there are no complications, you are young, and the condition of the scar is satisfactory according to ultrasound, a natural birth is possible.

Myoma is a benign tumor formed from connective tissue. It may be on the walls or in the uterine cavity. A fairly common disease. It is diagnosed in most cases by the age of 35 in 45% of women. Patients aged 35 to 50 years are at risk. The size of the tumor varies. In some cases, a small nodule is fixed, in others a ball weighing up to 1 kg. In the latter case, it can be easily felt by palpating the lower abdomen. The pathology does not appear immediately, but the later it is detected, the more difficult it is to treat. Along with the severity of therapy, the risk of complications, including infertility, increases. Most often, the cause of connective tissue proliferation is an increased amount of the female hormone - estrogen. Despite the fact that the tumor is benign, it brings significant difficulties to the woman, among which are uterine bleeding, as well as problems with conception. Women very often wonder whether pregnancy is possible after removal of uterine fibroids? To answer this question, you need to understand the reasons for the appearance of a tumor on the reproductive organ, and also study the methods of surgical intervention.

Causes of fibroids

The pathological changes in organ cells are based on a hormonal imbalance, including estrogens and progesterones. Violation of the norm leads to cell mutation and, as a consequence, its proliferation. Among the causes of the tumor are the following factors:

Fibroids can appear even during pregnancy. Such cases are diagnosed if a woman becomes pregnant late for the first time. Having determined the cause of the disease, it is necessary to eliminate it to eliminate problems with conception.

The effect of surgery on reproductive function

Removal of fibroids is carried out using a conservative method. After the operation, reproductive function is of course impaired. Depending on the type of surgical intervention, problems with conception are either temporary or permanent. Therefore, pregnancy after removal of fibroids is possible, but taking into account the method of the operation. There is a gentle treatment method that minimally injures the uterine tissue. After restoration of the organ shell, with the doctor’s permission, conception is possible. In some cases, the tumor is significant in size or in an unfortunate location, so doctors decide to remove the entire organ. In this case, a diagnosis of infertility is already made. According to statistics, removal of fibroids does not affect fertility in 85% of women. In the remaining 15%, it is not possible to save the functionality of the uterus (most often this number includes patients with severe complications of the genital organs).

Tumor removal methods

There are several removal methods:

Pregnancy after removal of subserous fibroids is also possible if the organ remains preserved. To conceive, you need to undergo a course of treatment and restore the functionality of the uterus. Only after the doctor's approval and tests is it possible to become pregnant. Myoma itself is not a cause of infertility, it only prevents the fertilized egg from attaching, therefore, after removal and restoration, the reproductive function of the female genital organs is quite functional. The main aspects in achieving a positive result are compliance with the doctor’s recommendations, pregnancy planning and careful preparation of both parents for conception.

Pregnancy after removal of fibroids should be planned and only after a certain period of time, which will be influenced by the type of operation - classic laparotomy, laparoscopy or hysteroscopy, and the speed of recovery. The average time to delay conception is six months to a year. It is during this period that the tissues will heal well, the scar will become dense, which will reduce the risk of possible complications during pregnancy.

In some cases, women become pregnant along with the formation, but this can lead to accelerated growth of the node, deformation of the uterus, placental abruption, malnutrition of the baby, and others.

Opinions differ on whether or not it is necessary to have surgery on the eve of pregnancy. As practice shows, women successfully bear babies even with a large number of such tumors. However, such a pregnancy often faces multiple pitfalls.

It is definitely believed that the following nodes need to be removed:

With rapid growth in recent times.
More than six centimeters in diameter - in this case they can deform the uterine cavity and prevent the fetus from developing normally. The baby may develop various abnormalities of the skeleton and soft tissues - depressions of the skull and chest, pathology of the development of the limbs, etc.
Multiple nodes more than three centimeters in diameter.
With submucous growth - if they increase towards the uterine cavity. Such nodes lead to placental abruption, disruption of the baby’s nutrition through the umbilical cord vessels and other abnormalities.

Types of fibroids depending on the location of myomatous nodes

Fibroids can be removed in several ways - through classical laparotomy surgery, laparoscopy or hysteroscopy.

Laparotomy surgery

It is considered the method of choice for those women who are planning a pregnancy. This is a classic option for surgical removal of nodes. The disadvantages of the method are the following:

A noticeable suture remains on the anterior abdominal wall - longitudinal or transverse.
The operation is accompanied by significant blood loss and pain.
The rehabilitation period is long – at least a month or two.

The main advantage of laparotomy surgery and removal of myomatous nodes in this way is the quality of the sutures applied to the myometrium. Only with his own hands can a surgeon compare tissues so carefully and suture everything layer by layer. Subsequently, this is a guarantee that the woman will be able to bear the baby without complications. The probability of rupture of the uterine body along the scar in such cases is no more than 5-7%.

Particular preference should be given to such operations in cases where myomatous nodes have interstitial growth and there is a possibility that the uterine cavity will be opened during the operation. Using the laparoscopic technique, it is impossible to apply sutures that will later lead to a full-fledged scar.

Laparoscopy as an option for removing uterine fibroids before pregnancy

Preference should be given to laparoscopy if a woman does not plan to become pregnant after removal of fibroids. In a non-pregnant state, the uterus after surgery will never give any complications. It’s another matter if a woman is still planning to give birth. In this case, only not very large (preferably up to 3 cm) nodes with subserous growth can be removed laparoscopically - they sit “like mushrooms” on the uterus.

And even in this case, preference should be given to classical laparotomy.

Several five years ago, after the introduction of laparoscopy and the understanding of its advantages over conventional operations, all women who were planning a pregnancy had their fibroids removed with this latest equipment.

However, following this, it was found that the course of pregnancy in women with previous laparoscopy for removal of nodes is complicated by uterine ruptures in the third trimester, often with fetal death and a real threat to the woman’s life.

Laparoscopic surgery

After a thorough analysis of the situation, it was concluded that laparoscopic myomectomy is not a method for those planning a pregnancy. The fact is that it is extremely rare to get full sutures. As a rule, the myometrium heals, but during pregnancy, as the uterus grows, the tissue cannot withstand the tension due to its incompetence and ruptures. Moreover, this happens instantly and often unnoticeably in the first minutes, but everything can end very tragically.

Other options

You can prepare for pregnancy using other medical advances in removing myomatous nodes.

For submucosal localization, preference should be given to hysteroscopy - this is the most minimally invasive and gentle operation in this case.

EMA

In some situations, uterine artery embolization (UAE) is suitable, after which the nodes decrease in size and do not cause concern during pregnancy. Studies of pregnant women after performing UAE for fibroids prove that the fetus develops normally and does not experience a deficiency in blood supply. The functions of the placenta are also not impaired.

Watch this video about in what cases a patient undergoes uterine artery embolization (UAE) to treat fibroids:

When can you prepare for pregnancy after surgery to remove fibroids?

After surgery to remove fibroids, you must refrain from planning a pregnancy for at least six months. This time is necessary for the tissues on the uterus to heal well and subsequently be able to fully change throughout the entire gestation period. This time can extend up to a year if the operation was complex, accompanied by large blood loss and removal of many nodes.

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

However, you should not delay planning your pregnancy. After removal of the nodes, there is a high probability that new foci of myomatosis will appear. And if you postpone pregnancy for several years, it is possible that new nodes will become an indication for another surgical intervention.

Preparing for pregnancy after removal of uterine fibroids

In general, approaches to pregnancy planning after removal of uterine fibroids do not differ from usual ones. The recommendations are as follows:

For three months, start taking folic acid, one tablet once a day, with your partner.
A woman should be examined by a gynecologist with a standard list of tests.
Undergo a full examination of sexual partners for infections.
Be examined by specialists if you have any chronic diseases, especially with taking pills - they may need to be replaced with others or stop using them altogether.

The course of pregnancy after removal of fibroids

How pregnancy will proceed after removal of fibroids largely depends on the diameters of the nodes, their location, the age of the woman and other related factors. However, all women are at increased risk for the following types of complications:

Incorrect implantation of chorion and subsequent abnormal location of the child's place. As soon as the fertilized egg descends into the uterine cavity, it begins to “search” for the most comfortable place for subsequent implantation.

Scar areas rarely “attract” the embryo to themselves; as a result, implantation occurs in atypical places - in the area of the internal os (low placentation and subsequently the marginal or central location of the placenta), and sometimes in the cervix itself. The latter is a pathological condition and requires surgical treatment.

Threats of abortion in early and late stages. As the uterus grows, its muscle layers should evenly increase and “stretch,” as it were. Scar areas are less susceptible to such transformations, so tone and the threat of miscarriage often arise, up to the formation of retrochorial hematomas.
Malposition. Often, after removal of large nodes, the uterine cavity changes its shape. This forces the baby to take atypical positions - oblique, leg, pelvic, transverse. This does not affect the gestation process, only the course of labor.

Ruptures of uterine tissue. The deeper the tumor was, the higher the likelihood. On average, the frequency of uterine ruptures after laparotomic operations is no more than 3%, after laparoscopic operations - 7-10%. As a rule, this occurs in the third trimester, when the muscular layer of the uterus has to stretch as much as possible. The woman usually feels a sharp pain, which subsides.

After this, there may be a decrease in fetal movements due to its acute hypoxia. In some cases, massive intra-abdominal bleeding develops, threatening the woman’s life.

Ingrowth of placental tissue into the scar area. It is possible that if the child’s place is located in the area of previously performed surgical interventions, the vessels literally grow into defective tissues. This can be detected by ultrasound in the second or third trimester.

Watch this video about the treatment of fibroids and subsequent pregnancy planning:

Features of labor management

The presence of scar changes on the uterus always worries doctors in terms of labor management. Most often they are inclined to perform a planned cesarean section. This is due to the fact that it is impossible to find out how the uterus will contract after removal of fibroids, even if the entire pregnancy proceeded well.

Uterine rupture along the scar can occur at the peak of any contraction. The likelihood of this increases during pushing. First of all, the baby suffers - a state of acute hypoxia occurs. In such situations, childbirth does not always end safely, and death for the fetus is possible.

Natural labor is possible only if a small fibroid with a subserous location is removed, and the operation itself takes place without opening the uterine cavity.

Pregnancy after removal of uterine fibroids is possible, but a woman’s chances of various pathological pregnancy are slightly increased. The planning process is no different from that of healthy women. You can think about pregnancy no earlier than four to six months after the operation - at the discretion of the operating doctor. Childbirth, as a rule, ends with a planned caesarean section.

Surgery to remove uterine fibroids is a surgical procedure performed only in extreme cases: when all other methods are completely ineffective.

Even if modern surgical techniques are used, women’s health is still at certain risk.

Depending on what stage the fibroid is at, it can be removed in two main ways (methods):

Myomectomy. The fibroid is excised along with that part of the uterine cavity in which the inflamed nodes are located;

Hysterectomy or complete removal of the uterine cavity.

Laparoscopic myomectomy is performed under general anesthesia or using laparoscopy. Removal of uterine fibroids using the laparoscopic method - partial removal of fibroids using a special instrument - a laparoscope, which is inserted into the peritoneal cavity through small incisions;

laparotomy myomectomy – complete removal of fibroids through incisions on the abdominal wall;

hysteroscopic myomectomy - getting rid of fibroids using a gasteroscope (an instrument inserted through the vagina into the uterine cavity). Hysteroscopic myectomy is indicated when submucous fibroids are detected, that is, growing in the lumen of the uterine cavity;

hysterectomy – complete, surgical removal of the uterine body;

Uterine artery embolization – blocking the blood flow through the uterine artery. This operation allows you to leave the uterine fibroids without nutrition, which will lead the tumor to complete death;

FUS ablation (ablation) of uterine fibroids is a relatively new treatment method that uses focusing ultrasound waves.

The laparoscopic method involves performing the procedure using a laparoscope and without large incisions in the muscle tissue, which can significantly speed up the healing process.

absence of postoperative pain, which allows you to do without taking analgesics;

short period of hospital stay (usually two to three days);

absence of postoperative scars and adhesions;

quick return to a normal lifestyle.

during pregnancy, uterine scars require additional monitoring of the woman;

the emergence of new nodes (relapses) is possible.

Pregnancy after removal of uterine fibroids is quite possible, since the entire body of the uterus is not removed.

Abdominal surgery has very serious consequences: after an incision in the abdominal wall, an ugly suture remains, which you have to hide from prying eyes for the rest of your life.

In addition, the woman receives severe psychological trauma, however, she should be aware that maintaining health is impossible without this operation.

submucous (submucosal) fibroids grow towards the lumen of the uterus and often lead to miscarriage;

subserous fibroids grow into the pelvic cavity, and not into the lumen of the uterus, which leads to menstrual irregularities.

The subserous nodes are cut off along a line located slightly above the pedicle (base) of the tumor. This is done in order not to create excessive tension at the site of suturing the tumor bed.

The advantage of the method is the dosed use of laser energy, which allows it to penetrate to a given depth without affecting neighboring tissues and organs.

After using the laser, there are no scars or stitches on the body of the uterus, which allows the woman to successfully become pregnant and give birth in the future.

the possibility of using laser therapy in nulliparous women;

outpatient surgery;

the period of time required for the operation is 30 minutes;

postoperative period – two to three days;

normalization of reproductive and menstrual function.

you should not push, as this can lead to an increase in intrauterine pressure and subsequent rupture of the sutures (do not eat products made from white flour);

eat pureed food, jelly, porridge);

mandatory restriction of physical activity is necessary (you can walk, but you cannot practice physical activity);

avoid small household chores (cleaning, laundry);

You cannot stay in the sun for a long time, or visit a bathhouse or sauna.

For example, if the operation was performed using an open method, then the recovery process is slower.

The patient is offered to limit physical activity, not forgetting that measured walking can only be beneficial and will contribute to accelerated healing.

In such cases, we should not forget that the desire to recover is the main secret of speedy rehabilitation.

The Frolov Phenomenon breathing device shows good results in the postoperative recovery of the female body.

The Frolov Phenomenon simulator device today is the only medical device that allows you to activate the hidden reserves of the female body, at the same time:

triggering the mechanism of tissue repair at the cellular level;

activating metabolic processes.

In addition, it is known that endogenous breathing has a beneficial effect on the female psycho-emotional sphere.

The Frolov Phenomenon device allows you to do without medical procedures and expensive medications, and this, in turn, quickly returns her to her normal life and completely restores the health of her reproductive system, while simultaneously reducing the possibility of relapse of the disease.

Let's say the main thing right away: removal of the uterus or its fibroids is not a direct contraindication for having sex.

Pain or discomfort during sexual intercourse only indicates the unpreparedness of the female body for normal sexual life.

In such cases, your best advisor can only be the surgeon who operated on you. Only he personally knows your physical data and can tell what complications and negative consequences may haunt you.

Maybe it’s best for you to use special lubricants to facilitate sexual intercourse, or maybe it’s best for you to wait a certain time so that nothing bothers you later.

After a hysterectomy, it is very important to use contraception correctly. In this case, you also need to consult your doctor.

In such cases, contraception is not needed at all, since removal of the uterus puts the woman into menopause. Many women even feel satisfied that they no longer have to worry about a sudden pregnancy.

Moreover, many women after surgery have not lost their ability to experience sexual orgasm.

If the uterus remains in a reproductive state (only the fibroids were removed), then the woman, of course, should resort to contraception to protect herself from unwanted pregnancy.

After surgery to remove uterine fibroids, you can usually have sex after a month and a half, and you can plan a pregnancy after about nine months to one year, depending on the general condition of your body.

The diagnosis of “uterine fibroids” while planning a child can frighten and lead to despair. After all, in essence, it is a tumor, although benign, but located in the place where the child grows and develops for nine very important months. And how can they be compatible? pregnancy and fibroids. Doubts about this are quite appropriate and expected, and only a doctor can dispel or confirm them during a personal examination.

As mentioned above, fibroids are a benign change in the muscle layer of the uterus, or rather, the growth of quite ordinary muscle cells as a result of improper division. Recent studies show that fibroids are usually not prone to malignant transformation. The probability of this is only 0.3%. The same number as the rest of the uterine cells.

This point is very important in discussing this topic. After all, it is advisable for a woman who is planning to become pregnant if there are fibroids in the uterus to find out about all the problems that she may encounter.

Unnaturally increased uterine tone during pregnancy, caused by myomatous nodes.

Impaired blood supply to fibroids as pregnancy increases and the walls of the uterus stretch, leading to inflammation of the node and even its disintegration. In addition, this condition is accompanied by increased uterine tone and serious pain.

Attachment of the placenta in the area where the myomatous node is located and disruption of its correct formation, which in the early stages can cause miscarriage or fading of pregnancy and fetoplacental insufficiency or premature placental abruption in later stages.

No doctor can accurately predict how the nodes will behave during pregnancy. Some of them increase, others, on the contrary, decrease and even cease to be visualized on ultrasound. However, most often after childbirth, all fibroids return to their previous size. Therefore, pregnancy in combination with fibroids requires increased attention from the supervising doctor and the pregnant woman herself, since measures to prevent uterine tone and destruction of fibroids in such situations are quite important. It follows from this that the sooner a woman stops registering, the better for her.

healthy long sleep;

absence of any physical activity and stress;

additional ultrasound of myomatous nodes and placenta, if it is located on the node or next to it.

In the case of fibroid inflammation, rapid detection of this pathology is very important, since further treatment - medicinal or surgical - depends on this. The main thing is to restore the blood supply to the fibroids; for this, they often resort to the same drugs that are prescribed for disturbances in placental metabolism. In addition, medications are used to eliminate tone, pain or bleeding, if necessary.

The help of a surgeon is usually required in very rare cases when conservative treatment is ineffective and the fibroid continues to deteriorate. Surgery to remove fibroids The laparoscopy method, although tolerated quite easily, is performed according to absolute indications, as it carries a certain risk of miscarriage. It is believed that the risk to a woman’s health is minimal.

Laparoscopy is the most suitable method for removing fibroids during pregnancy. The recommended favorable time frame for removal is starting from the 16th week. After reaching 32 weeks, the size of the uterus becomes too large for such an operation.

Childbirth with fibroids also requires special attention. For example, it happens that a large fibroid is located in the cervix area. In this case, a barrier is created for the baby and a cesarean section is often required for delivery.

Also, due to myomatous nodes, there is a slightly higher likelihood of disruption of the coordinated work of the uterine muscles during contractions or weakening of labor. Incomplete separation of the placenta is also possible.

In addition, a uterus with multiple nodes may take longer to return to its normal state than a uterus without fibroids.

A fairly common question is “ Is it possible to get pregnant with fibroids??. Submucosal fibroids, which essentially grow on the inner lining of the uterus into its cavity, can become a serious obstacle to conception. For example, they may prevent sperm from reaching an egg or a fertilized egg from implanting in the endometrium. In addition, it is known that large fibroids can compress the fallopian tubes.

In turn, small nodules (less than 2 cm) located in the muscular layer of the uterus rarely have a negative effect on embryo implantation. They are the safest among all types of fibroids. Most often, the course of pregnancy does not have any peculiarities. And if there are no other reproductive health problems, then conception is highly likely. However, in any case, it is highly advisable to consult a surgeon before planning, since for some types of fibroids pregnancy may not be recommended. These are the so-called pedunculated nodes, prone to twisting and malnutrition, nodes located in the submucosal layer of the uterus and large fibroids any location, because the larger the size of the fibroids, the higher the risk of premature birth.

In order to avoid various complications associated with problematic fibroids during pregnancy, doctors recommend their removal after preliminary therapy aimed at reducing the size of the fibroids. Modern technologies make it possible to achieve this without traumatic manipulations and removal of the entire uterus. After removal of uterine fibroids Pregnancy planning is permitted on average after about 6 months.

Myoma is a benign tumor. The main reason for its formation is hormonal imbalance, or rather high levels of estrogen. The probability of fibroids degenerating from benign to malignant is 0.3%. In most cases, these are tumors of various sizes and shapes. In 5% it develops in the cervix, and in the rest - in the body of the uterus.

Such a diagnosis is a shock for a woman, especially if she is about to become pregnant for the first time. Despite this, the vast majority of women successfully become mothers and give birth to healthy babies.

Small uterine fibroids do not create any special problems for conceiving and bearing a child. How to treat uterine fibroids with herbs can be read in this article.

Uterine fibroids and pregnancy are completely compatible concepts. IN

If the fibroids are small (3-4 cm) and located outside the uterus, the chance of getting pregnant is quite high. However, there is also a high risk of miscarriage, disruption of the contractile function of the uterus during labor and other complications. It is impossible to conceive a child only in such cases if:

a tumor has formed in the uterine cavity and interferes with the attachment of the fertilized egg;

the formation blocks the entrance to the fallopian tubes and thus prevents sperm from meeting the egg.

Under favorable conditions, you can get pregnant naturally and with the help of IVF. The likelihood of conception will decrease if a woman has concomitant diseases of the internal genital organs: endometrial polyps, endometriosis, polycystic ovary syndrome and other chronic diseases.

For successful fetal development, a woman should register with a doctor as early as possible. Depending on the size of the tumor and related factors, the gynecologist will determine further actions. Whether to remove the tumor or not will depend on the size of the node.

The next stage after conceiving a child is maintaining the pregnancy. After all, there is a real threat of abortion. A benign tumor is dangerous because:

Myomatous nodes can provoke an increase in uterine tone;

As pregnancy progresses, the walls of the uterus stretch and the blood supply to the tumor is disrupted. This can lead to inflammation of the fibroids, accompanied by severe pain and increased tone of the uterus;

If the fertilized egg is attached to the location of the fibroids, the likelihood that the placenta will not form correctly increases. This can be the cause of frozen pregnancy, placental insufficiency and spontaneous abortion. In the 3rd trimester, premature placental abruption may occur.

No one knows what will happen to myotic nodes during pregnancy, even an experienced gynecologist. Some neoplasms resolve, others shrink, and others, on the contrary, only increase in size. It is known that after childbirth, tumors regain their original size.

The sooner a woman with fibroids consults a doctor and gets registered, the better. Pregnant women with this disease require increased attention from a doctor. She may be prescribed a course of treatment in order to get rid of the formation and undergo prevention of increased uterine tone. Mostly, with this pathology, children are born by caesarean section.

additionally undergo an ultrasound scan of the tumor and placenta;

completely avoid physical and psychological stress;

rest more.

If fibroids become inflamed, you should consult a doctor and undergo medication, if necessary, and surgical treatment. Medicines are prescribed to reduce pain and bleeding and reduce muscle tone. To restore blood supply to the tumor, drugs are prescribed to regulate placental metabolism.

If drug treatment is ineffective, the woman undergoes surgery. Its essence is to remove the node using the laparoscopic method. Typically, such operations are performed from 16 to 32 weeks of pregnancy. There is a small risk of miscarriage.

A benign tumor in itself is not a cause of infertility. But if all established causes of infertility are identified, removal of the tumor will significantly increase the likelihood of conception. This applies to fibroids that are no more than 12 weeks old. It is more difficult to maintain the ability to bear a child after removal of a large tumor. The operation can be complicated by bleeding and, in rare cases, even removal of the uterus. If the operation is successful, you can plan a pregnancy in a year. It all depends on the size of the node, the nature of the operation and postoperative complications.

The presence of fibroids is a factor complicating the course of childbirth. Preliminary hospitalization in the maternity ward is recommended for preparation at 37-38 weeks of pregnancy. In women with small subserous or intramural nodular formations without concomitant pathologies, natural childbirth is preferable.

low location of the nodes, preventing the opening of the cervix and the advancement of the fetus;

multiple nodes or large size of a single formation (diameter 10 cm or more);

a scar on the uterus after myomectomy, the consistency of which indicates a risk of rupture;

malnutrition of the node, leading to necrotic, inflammatory and dystrophic changes in unchanged areas of the uterus (metritis);

suspected degeneration or necrosis of fibroids (rapid growth, large size, soft consistency, local pain, anemia);

combination with other diseases and complications of pregnancy;

Placental polyp during pregnancy and after childbirth, as a complication, requires observation and treatment from a specialist. Find out what the thickness of the endometrium should be here.

Complications during childbirth may occur, such as untimely rupture of water, abnormal contractile activity of the uterus, tight attachment of the placenta, hypotonic bleeding, which require emergency delivery. Often, a cesarean section in the presence of a tumor ends with the removal of the node or organ completely.

A woman planning to conceive a child should be regularly monitored by a doctor and take preventive measures to prevent the formation of new tumors with the help of medications. Timely consultation with a doctor, attention to your health and a great desire to have a child are the main criteria for successful conception, normal gestation and timely birth.