Home Vegetable garden on the windowsill How was your IVF protocol with fibroids? IVF and uterine fibroids - is pregnancy possible? Surrogacy for myomatous nodes

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How was your IVF protocol with fibroids? IVF and uterine fibroids - is pregnancy possible? Surrogacy for myomatous nodes

IVF and surrogacy for uterine fibroids

Can't get pregnant due to fibroids? Have you had multiple miscarriages? Is there really a chance of being born? healthy child almost not? Don't give up! We know how to help you become a mother!

Cost of treatment

Initial consultation with an obstetrician-gynecologist before surgery - for free
Hysteroresection of a submucosal fibroid node of 1st category of complexity - 30,000 rubles
Hysteroresection of a submucosal fibroid node of the 2nd category of complexity - 40,000 rubles
Hysteroresection of a submucosal fibroid node of the 3rd category of complexity - 50,000 rubles

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What is fibroid?

Uterine fibroids are the most common benign tumor female reproductive system. The prevalence of this pathology is extremely high - about 20% of women reproductive age suffer from uterine fibroids.

About half of women with uterine fibroids have some kind of reproductive dysfunction. Since this disease is more common in patients of older reproductive age, their reproductive function can be further worsened by a decrease in ovarian reserve and somatic diseases. Problems with conception are also contributed to by factors that often accompany fibroids: endometriosis, endocrine disorders.

Uterine fibroids and IVF

During an IVF program, fibroids can negatively affect the implantation of the embryo into the uterine cavity; Also, in patients with fibroids, the risk of miscarriage increases sharply. For maximum effectiveness of the IVF protocol and successful pregnancy, women with uterine fibroids require careful examination and treatment before planning a pregnancy.

The tactics for monitoring and treating fibroids before starting an IVF program depends on the number and size of myomatous nodes, as well as their location relative to the uterine cavity.

Numerous studies have found that fibromatous nodes up to 3 centimeters in size, which do not deform the uterine cavity, do not affect the IVF program. Therefore, in the presence of interstitial and interstitiosubserous myomatous nodes, do not large sizes that do not deform the uterine cavity, surgical treatment before the program is not indicated.

Interstitial and interstitial subserous myomatous nodes of large sizes, myomatous nodes that deform the uterine cavity are subject to surgical treatment. Depending on the size, number and location of nodes, the method of choice for surgical treatment is conservative myomectomy by laparoscopic or laparotomy.

If submucosal uterine fibroids of any size and interstitial location of the node with deformation of the uterine cavity up to 4 cm in size are detected, the myomatous nodes must be removed by hysteroresectoscopy.

If there are contraindications to surgical treatment, a good alternative for preparing patients with fibroids for the IVF program is

After surgical treatment, regardless of the access and technique, planning an IVF program is recommended no earlier than 6-12 months, since during this period the formation of a strong scar on the uterus occurs. For the first time after treatment, the possibility of planning a pregnancy is assessed after 6 months. However, after surgical correction of uterine fibroids, it is better to plan an IVF program no later than 1-1.5 years after treatment, since the risk of fibroid recurrence is high. Re-growth of myomatous nodes can serve as a factor reducing the effectiveness of IVF treatment for infertility.

Drugs used to stimulate superovulation in IVF programs can indirectly affect the growth of myomatous nodes, therefore the type of program and scheme for stimulating superovulation is always determined strictly individually; Longer protocols using GnRH agonists are generally preferred.

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Uterine fibroids and surrogacy

In the presence of uterine fibroids, there are no clearly established indications for an IVF program involving a surrogate mother. Usually, surrogate mother is involved in the program for the following indications:

large uterine fibroids, without the possibility of corrective treatment
uterine fibroids with severe deformation of the cavity, without the possibility of corrective treatment
cicatricial deformation of the uterine cavity after surgical interventions
failure of the uterine scar after removal of myomatous nodes
synechia of the uterine cavity after surgery.

How can pregnancy affect uterine fibroids?

When pregnancy occurs, under the influence of changed hormonal levels, dynamics in the growth of myomatous nodes may be observed. It has been noted that large myomatous nodes tend to grow, while the growth of small nodes (up to 5 cm) in most cases stabilizes. According to numerous studies, about half of the nodes up to 5 cm that were detected before pregnancy were not detected on ultrasound after childbirth.

What complications can occur during pregnancy if you have uterine fibroids?

risk of threatened miscarriage in the first and second trimesters, premature birth in the third trimester of pregnancy;
development of fetoplacental insufficiency
deterioration of blood circulation of the myomatous node up to its necrosis
premature placental abruption
early and late postpartum bleeding
development of labor anomalies during childbirth, uterine rupture along the scar;
premature rupture of membranes
thrombotic complications.

As a rule, uterine fibroids are not a contraindication to vaginal delivery. Surgical delivery is indicated in the presence of necrotic changes in the myomatous nodes, complicated pregnancy, atypical location of the nodes (for example, if the myomatous node is located low and disrupts the process of fetal passage through birth canal mother). After undergoing a conservative myomectomy, the decision on the method of delivery is always made strictly individually.

Questions for specialists

Eco Elena, 09/18/2019

Good afternoon Please tell me I had a laparoscopy with tube removal. How much recovery time is needed to start an IVF protocol? And another question: can a husband donate sperm in advance and use frozen sperm for transfer in the protocol? Since there will be no way to come to the transfer

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Empty follicles Irina, 09/18/2019

Good afternoon. 1 protocol-amg 1.67; 32 years; stimulation gonal 187.5 trigger diferelin 0.2: 7 oocytes were obtained, on day 5 1 embryo. 2 protocol-amg 1.26;34 years; stimulation pergoveris 150+gonal 75; trigger ovitrel 250: not a single oocyte. Stimulation didn't work or? Cause? How to stimulate further?

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Medical services poor quality Nadezhda, 09/16/2019

Hello, in another clinic they did a cryotransfer, the doctor did not look at any of the latest tests done specifically for this transfer, only with 2 hormones, can this be regarded as negligence, did the doctor have the right to prescribe medication in support, without even knowing the results of the analysis blood, urine, etc. I'm planning to apply for a refund. Money for service rendered of inadequate quality

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Uterine fibroids in combination with adenomyosis Irina, 09/12/2019

Dear Maxim Stanislavovich! I want to contact you with my problem. Now I am 30 years old, I have one 3-year-old child. For 10 years I have been seeing a gynecologist due to the presence of multiple fibroids in combination with adenomyosis. The nodes do not stand still; there is growth dynamics. I have been seeing one gynecologist for a long time, but I also go to others for additional consultations. All the doctors, while doing ultrasounds, ooh and ahh about what’s wrong with my uterus at such a fairly young age. No one prescribed any treatment. We almost couldn't get pregnant more than a year, we wanted to stimulate the ovaries and send her for IVF, but we managed to get pregnant on our own and carry her to term without any problems. After going to the doctor, who is already observing me and my organ for a long time, said that everything is bad, everything is growing, she is afraid of degeneration into sarcoma and said that the uterus must be removed, the ovaries remain, everything is fine with them. But she sent me for a definitive consultation with a doctor who does surgeries, she looked at the last ultrasound, looked at it on the chair, and said, everything is huge, it needs to be removed, but since I am quite young, and removal is always possible, and this is the last thing that can be done, She said, let’s try 3 injections of Luprid Depot, there are cases where everything decreases significantly and you can postpone the operation for some period. Now there are no plans for a second child with her husband, if only later, but she said there are no deadlines, either now after the injections, or never. In general, I was offered 2 options - inject myself and see what happens next, or lie down and remove the uterus and cervix. The last ultrasound was on August 22, 2019, on the 7th day of menstruation, uterine dimensions: length 120 mm, anterior-posterior. 119, width 120, uneven contours, non-uniform structure, inter.subser along the front wall. m/u 36×30, in the day 52×30mm, this is what can be measured with a device, so the entire uterus is dotted with small nodes, like grape bunches, endometrium 7 mm-1 phase, left ovary 34×15, unchanged, right 35 ×18, no changes. Conclusion: multiple uterine fibroids in combination with adenomyosis. Before that, the previous ultrasound was done on April 6, 2019, uterine dimensions: length 98, anterior-posterior. 110, width 115, uneven contours, heterogeneous structure, differential, along the front wall inter. subser. m/y 38×32, nearby 35×31mm, endometrium 12 mm, ovaries without changes. So from April to August the uterus has enlarged and now corresponds to 14 weeks of pregnancy, my doctor considers the only solution to be removal. The only way out She also considers injecting injections, but then to cancel, put on a Mirena spiral for 5 years and not touch the uterus. Other nynecologists don’t even know what to do with me and say directly, we can’t help, you need specialists of a completely different level, I’m unlikely to find them in Gomel. An aspirate was taken from the uterine cavity on June 6, 2019, according to the results everything was normal, the diagnosis was fibroids combined with adenomyosis, endometrial pathology. Termination: endometrium in the secretion phase, middle stage. I donated blood for tumor markers CA 125 -33, 11, HE 4 -81.53, ROMA premenopausal -21.31, ROMA postmenopausal - 27.87, PEA/CEA - 0.919. Hemoglobin 147, serum iron 21.7, ferritin 38.2. In addition to this, my gynecologist sent me to treat a cyst on the cervix, there was always an inflammatory type of smear, the cytology was normal, she said go treat it, suppositories won’t help, nothing will help, go treat it, you’ll come back like a new penny with a good cervix. I went for an additional paid colposcopy, the doctor said it was a purulent cyst, it needed to be treated, it was like a pimple on the face with contents and it would not disappear anywhere. On April 8, for a fee, a professor performed radio wave ablation of my cervix, two months later I came to see this professor, did a colposcopy, said everything has healed, live as you lived before and sent me home. I went again to another specialist for a colposcopy, she looked and said the wound had not yet healed at all, let it heal for another 2 months and not go in there. And the last doctor I saw, who was operating and said to try injections for now, when examined on the chair, she said that the cervix was in poor condition, that there were foci of endometriosis on it and this was most likely after ablation. She even took a photo and showed how inflamed it was, red-burgundy in color, that’s why she said that if the uterus is removed, I won’t leave you with such a cervix, it’s in bad condition. And if you give injections, then within 3 months, while I’m getting the injections, I’ll have my neck treated again, but not by the professor who did the ablation. They took an aspirate because after this ablation I bleed on the 16th day of my period and before the start of the next one, and so on from month to month, although this had never happened before with all my problems. My gynecologist said that this is not related to the ablation, it just coincided, your endometriosis is making itself felt, so to rule out the worst, they took an aspirate for me. And this doctor who performed the operation said that it was the cervix with endometriotic lesions that was bleeding. They say about EMA that I can’t do it, since my entire uterus is covered with bunches of grapes, this is not my option. This is the situation. Sorry for such a long text. What is possible in my situation, please tell me. Or there are no options, only removal of the uterus and cervix. But 30 years, somehow completely cruel... Our doctors have this opinion, it’s bleeding, the cervix is bad, the uterus is all covered with nodes, everything is growing, endometriosis, only for removal with the help abdominal surgery. To be honest, I don’t see the point in taking Luprid depot injections. What will happen to me after they are canceled... I think about it. And is there a need to remove the uterus and cervix in my situation? Thank you in advance!

Benign neoplasms of the uterus are common gynecological pathologies that are accompanied by mass unpleasant symptoms and lead to infertility.

That is why many married couples dreaming of a child are concerned with the question “is IVF possible for uterine fibroids?”

Only a gynecologist can answer this question after a comprehensive examination.

Myoma is a benign formation that occurs as a result of the accelerated division of smooth muscle or connective tissue cells in the uterus. Depending on the histological type, leiomyoma, fibroma and mixed tumors (fibromyoma, myofibroma) are distinguished. Currently exact reason, leading to the occurrence of pathology, has not been established, however, there are hormonal and hereditary theories of the appearance of nodes.

The disease most often occurs in premenopausal women, but in last years the disease is rapidly getting younger.

It is believed that risk factors leading to the development of uterine fibroids in young women are:

Poor ecology (polluted atmospheric air, water), with residents of large cities especially affected.
Frequent stress. Psycho-emotional and physical stress.
Sedentary lifestyle, sedentary work.
Overweight.
Taking hormonal drugs.
Endocrine and cardiovascular pathologies.

Many of these factors cannot be influenced, which is why this gynecological pathology worries many women.

Why doesn't pregnancy occur?

There is an opinion that infertility occurs due to benign tumors of the uterus, since natural fertilization is impossible. However, in reality, this is not the case. Uterine fibroids arise as a hormone-dependent structural disorder localized in the uterine cavity and leading to disturbances in different stages conceiving and bearing a child.

Nodes in the uterus lead to:

Impossibility of conceiving a child.
Spontaneous abortions.
Premature birth.
Narrowing and deformation of the birth canal, which is an absolute indication for a caesarean section.
Postpartum complications occur – profuse uterine bleeding, inflammation of the uterus, sepsis.

The onset, course of pregnancy and the birth itself are affected not so much by the fibroid as by its size, location and the presence of complications. It is necessary to decide on the possibility of natural conception, pregnancy and in vitro fertilization in the presence of nodes in the uterus with the attending physician after a thorough examination.

Artificial insemination for fibroids

Uterine fibroids and ecology with it are the most frequently asked question, which worries women who are faced with infertility due to this disease.

Most experts are inclined to believe that it is undesirable to carry out the IVF procedure in the presence of any, even benign, neoplasms, due to:

The uterine cavity with fibroids is most often deformed, which leads to difficulty in implantation during pregnancy.
Fibroids are a hormone-dependent pathology, so even small nodes during pregnancy can significantly increase in diameter and affect the developing fetus.
The birth canal, altered and narrowed by the tumor, prevents the normal advancement of the fetus during natural childbirth.

As a result, in most cases natural conception with fibroids and eco is contraindicated.

When planning a pregnancy, it is necessary to undergo a thorough examination and, if necessary, a course of treatment to prepare the body for pregnancy and childbirth.

Treatment of pathology and pregnancy

Experts have proven that infertility caused by uterine fibroids is reversible and goes away after treatment of the pathology. When planning a pregnancy with fibroids, it is important to consult a doctor and choose the most effective treatment tactics, after which, in most cases, the long-awaited pregnancy occurs.

You can get rid of nodes in the uterus using conservative and surgical methods.

Drug therapy includes:

Taking gonadotropin-releasing hormone antagonists (Zoladkes).
Treatment with combined oral contraceptives (Regulon, Novinet).
Correction iron deficiency anemia(iron supplements).
General strengthening therapy (taking vitamin and mineral complexes).

Under the influence of hormonal drugs, myomatous nodes stop growing and can also shrink, thereby facilitating conception.

Surgical treatment for tumors in the uterus is indicated when drug therapy is ineffective, as well as for large (uterine size over 12 weeks of pregnancy) and rapidly growing nodes. Surgical interventions include FUS ablation, uterine artery embolism, node resection and hysterectomy.

The scope of intervention is determined by a gynecologist. The choice of surgical method depends on the size and location of the pathological process, as well as on the presence of complications in the woman.

IVF after surgery

Is IVF done for fibroids after surgery, and what difficulties will you encounter?

This is a question that concerns women who have undergone surgery on the uterus. Only a gynecologist can answer this question and assess the possibility of artificial insemination. The likelihood of success of the procedure depends on the condition of the woman, the volume and effectiveness of the operation performed.

The most effective organ-preserving surgical interventions for fibroids include:

Embolization of the uterine arteries. A method in which a special substance is injected through the femoral artery into the vessels supplying blood to the tumors, blocking their lumen. As a result, the nodes decrease in size and “shrink out.” The advantages of this operation include its high efficiency, painlessness and quick recovery period.
FUS ablation- a method, the essence of which is the coagulation of the myomatous node with focused ultrasonic waves. The clinical effectiveness of the method depends on the location and histological structure of the node.

Patients, after the operations, are subject to dynamic monitoring for a year. In the absence of complications, recurrence of fibroids and other contraindications, they can undergo the IVF procedure.

In what cases is IVF not possible?

Unfortunately, even with the treatment of uterine fibroids, in some cases the artificial insemination procedure is not performed.

IVF is an expensive operation that doctors will not perform if the chances of successful implantation of the embryo, its full gestation and childbirth do not exceed 20%.

Artificial insemination is contraindicated if:

Large neoplasms, accompanied by heavy bleeding and deforming the uterine cavity and cervical canal.
Scars on the uterus left after resection of nodes.
Hystrectomy (during this operation, the entire uterus is completely removed, making pregnancy impossible).

You need to decide on the possibility of an IVF procedure with your doctor on an individual basis, 3 months after the operation. It is believed that during this time the damaged hormonal background and the examination will be as informative as possible.

In vitro fertilization for untreated fibroids

Is it possible to do IVF for fibroids that have not been treated?

A frequent question that arises among representatives of the fair sex who, for some reason, have not undergone a course of conservative therapy and surgical intervention.

IN in this case, the artificial insemination procedure is associated with high risk, both for mother and child and is performed extremely rarely. IVF is possible if:

The nodes in the uterus are small (up to 3 cm in diameter) and do not grow under the influence of hormones.
The neoplasms do not deform the uterine cavity and the cervical canal (most often these are fibroids located in the intermuscular layer or under the serous membrane).

In any case, pregnancy with uterine tumors requires constant monitoring by an obstetrician-gynecologist. This is due to the fact that under the influence of hormonal levels, which change with each month of gestation, fibroids can increase in size and be accompanied by complications that threaten both the mother and the unborn child.

Choosing an artificial insemination protocol

If the specialist has given the go-ahead for IVF, it is necessary to choose a protocol with a minimum dosage of hormonal drugs that may affect the disease. The effectiveness of the procedure depends on the size and location of the residual formation.

Pregnancy with artificial insemination occurs the first time in 38% of cases with:

Myomatous nodes (up to 3 cm in diameter) that do not deform the uterine cavity.
The location of the formation on the posterior wall of the uterus.
Fibroma, the growth of which does not depend on the level of female sex hormones in the blood.

The IVF procedure itself for fibroids has no special features and consists of the stages of stimulation, puncture, fertilization and attachment.

Uterine fibroids in most cases with timely and proper treatment is not a contraindication for artificial insemination. It is very important to undergo regular preventive examinations with a gynecologist, for the purpose of early detection and timely treatment of pathology, which increases the chances of a successful pregnancy naturally and with IVF.

The only remedy for FIBROID and its prevention, recommended by Natalya Shukshina!

A fibroid is a benign tumor that develops on or inside the uterus. Exactly this pathology often causes serious failures menstrual cycle, leads to sudden termination of pregnancy, premature birth. In addition, uterine fibroids may cause difficulty conceiving, especially if the formation is accompanied by other reproductive disorders. What do doctors recommend doing in such cases and how likely is a positive outcome from IVF?

How does fibroid affect pregnancy?

Education formed from muscle tissue, develops against the background of rising estrogen levels. The growth of fibroids is caused by changes in the functioning of the ovaries, so in most cases this diagnosis is made to women who have crossed the 33-year mark. The causes of the pathology are still not fully understood, so many questions remain open.

As a rule, with fibroids, a woman’s ability to bear children is not impaired. According to statistics, many patients with this diagnosis successfully become mothers. But in some cases, infertility is still a disorder accompanying fibroids.

The success of conceiving and carrying a baby depends on several factors.

Pregnancy planning is directly affected by the size of the formation and its location. You can obtain such data by undergoing an ultrasound examination.
The question “What to do with uterine fibroids?” is decided depending on the type of benign tumor. The safest in terms of the upcoming pregnancy are subserous and intramural formations, while submucosal or submucosal fibroids can increase the risk of infertility and spontaneous miscarriages.
You can count on a positive outcome if fibroids do not cause deformation of the uterine cavity. In other words, education must have a minimum size.

Treatment for fibroids or pregnancy?

According to doctors, if infertility and fibroids are simultaneously occurring pathologies, treatment of the tumor can solve the problem. You can try to conceive a baby with uterine fibroids for a year without carrying out therapeutic measures. If no positive changes are observed, proceed to conservative treatment.

If there is no result and after the therapy, the question of IVF arises. Typically, such a measure is necessary when uterine fibroids are accompanied by the formation of adhesions in the pelvic area, endometriosis, inflammatory processes in the body of the reproductive organ or appendages, or a disorder of an immunological or neuroendocrine nature.

Uterine fibroids and IVF - characteristic nuances

In vitro fertilization is a fairly expensive procedure, so successful embryo implantation is highly desirable. Doctors recommend deciding on this option of conception only if the fibroids do not deform the uterine cavity. Can be done artificial insemination and after conservative treatment of education. In both cases, the probability of a long-awaited pregnancy is about 20%. In order for this figure to be maximum, separate requirements are imposed on the stimulation of ovulation carried out in an IVF cycle.

How is superovulation initiated?

IVF for patients diagnosed with uterine fibroids should be done using the following methods of stimulating ovulation.

Short protocol. It's about about the simultaneous administration of gonadotropic drugs and GnRH a. Procedures begin on the second or third day of the cycle. This protocol is optimal solution when identifying multifollicular ovaries. With its use, the pregnancy rate reaches 36%.
Long protocol. Daily injections of Diferelin and Suprefact are given. Subcutaneous injections should be given in the navel area in the middle of the luteal phase (days 19-22 of the cycle). If the follicular reserve of the ovaries is normal, the probability of intrauterine pregnancy with uterine fibroids is about 38%.
Administration of GnRH antagonists.

As for the effectiveness of IVF for uterine fibroids, it depends on the form of formation.

If the myomatous node does not violate the contours of the cavity, provided that the size of the formation is a maximum of 3 cm, Negative influence excluded for IVF. For one attempt, the pregnancy rate is slightly higher than 37%, so artificial insemination can be performed without prior surgery.

If a conservative myomectomy was performed

The use of long and short protocols allows one to expect pregnancy with a probability of 37 and 35%, respectively. If antagonist administration is used, IVF works in a quarter of cases.

To achieve a positive result, it is advisable to do IVF after surgical treatment within a year, since after this period a recurrence of fibroids may occur, which negatively affects the effectiveness of the procedure.

If the myomatous node has an intramural localization

In this case, the middle muscular layer of the uterus becomes the site of formation, resulting in deformation of the reproductive organ and an increase in size. With this scenario, the effectiveness of IVF is significantly reduced, reaching a value of 12.5%. In addition, even with successful implantation of embryos, spontaneous miscarriages or childbirth cannot be ruled out. ahead of schedule. Because of such complications, doctors recommend artificial insemination only after radical surgical treatment.

As you can see, uterine fibroids are not always an obstacle to conceiving a child, including the procedure of in vitro fertilization. The main thing is to correctly correlate all the factors and choose the most appropriate way to prepare for the procedure, thus increasing the chances of success.

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Essence of fibroids
Is it possible to do IVF with fibroids?
Treatment of fibroids before IVF
IVF after treatment

Unfortunately, IVF and uterine fibroids are often incompatible things. Many women suffering from this disease may experience difficulties: in most cases, pregnancy becomes impossible, and in vitro fertilization contraindicated. However, even from this difficult situation there is a way out.

Essence of fibroids

Fibroids are a fairly common disease that many women face. In recent years, the age of patients has changed: there are cases when the diagnosis of uterine fibroids is made before the age of 25. This is due to poor environment, lifestyle, taking complex medications, genetics, as well as some other individual factors. The nature of the appearance of this complex disease has not been fully elucidated.

Myoma is a consequence of rapid cell division. This disease should not be confused with cancer, because fibroids are a benign neoplasm that can be detected on early stages development and safely remove. If a woman carefully monitors her health and regularly seeks advice from a gynecologist, there will be no problems with early diagnosis. There are some symptoms that can signal the appearance of such a neoplasm:

Cycle disruption (delay).
Pain in the back, lower abdomen.
Too much copious discharge during menstruation.

If you find these symptoms in yourself, you should immediately contact a specialist.

In most cases, after removal of fibroids, a woman can safely become pregnant and bear a healthy child.

Return to contents

If a woman is diagnosed with fibroids, her doctor will recommend either medication or surgery. IVF is not recommended for fibroids. This can not only lead to a difficult pregnancy, but also permanently deprive a woman of the opportunity to give birth to children.

Before undergoing in vitro fertilization, a woman must undergo a full examination, which will determine whether she has any contraindications or disorders. If fibroids are detected, the patient is not included on the list for IVF. The neoplasm can prevent the embryo, which is introduced into the uterine cavity, from taking root. Thus, the tumor will simply displace the unborn child, and the woman may experience serious problems up to infertility.

In some cases, fibroids turn out to be too advanced. Then it is removed along with the uterus, after which the woman cannot have children. This is why it is necessary to visit a gynecologist, especially if a woman is preparing to become a mother.

After removal of the tumor, the patient undergoes a second examination, based on the results of which a final decision is made. Usually the patient can become pregnant.

Return to contents

If a woman is diagnosed with fibroids, treatment must be started immediately. Some patients follow a policy of non-intervention and wait until the last moment for the tumor to disappear on its own. Unfortunately, such miracles practically never happen, and after some time the doctor performs either a myomectomy (removal of nodes) or a hysterectomy (removal of the entire uterus). In the first case, there is no guarantee that the woman will be able to get pregnant. This is due to the fact that deformation of the uterus occurs during the course of the disease.

However, not only these solutions to the problem are provided modern medicine. Gynecologists often resort to hormonal therapy, which relieves the woman of the problem. The course of treatment for each patient is strictly individual.

An alternative method may be uterine artery embolization (UAE). This procedure is painless and effective: a special substance is injected into the femoral artery, which clogs the vessels, and the nodes gradually “dry out”. It is also important that to carry out such a procedure, the patient must spend only 1 day in the hospital, after which only the supervision of the attending physician is necessary.

Return to contents

After successful treatment, a woman can go to the clinic to be re-examined for IVF.

In most cases, the result is positive, and patients successfully become mothers.

It is recommended to re-register 2-3 months after removal of the tumor. IVF after fibroids is an important procedure that requires repeated diagnostics. During this time, women's reproductive system will begin to function normally, the cycle will stabilize, hormonal balance will return to normal.

Please note that relapses are possible after treatment. They appear due to the fact that unfavorable processes are still going on in the body. Protect yourself from stress, do not take complex medications that can negatively affect your health. women's health. It is important to completely eliminate the consumption of alcoholic beverages and junk food.

Myoma and IVF

How does the condition of the endometrium affect IVF?

The endometrium is the inner lining of the uterus, the task of which is to receive the embryo and provide it with nutrients for successful development on early stage, the placenta has not yet formed. If the endometrium develops incorrectly, even a viable embryo may not implant and IVF will fail.

IVF: who does it?

The IVF procedure is a complex multi-stage treatment. Since the problem of infertility is complex, it often includes both male and female female factor, at different stages different specialists are involved in the treatment process.

Sick leave with IVF: who is entitled to it?

To undergo an IVF procedure, a woman will need to visit the clinic several times, and in most cases, undergo an ovarian stimulation program hormonal drugs

Tax deduction for IVF: we return correctly

The in vitro fertilization procedure is an expensive type of treatment (clause 27 of Russian Government Decree No. 201 of March 19, 2001), which means that part of the costs can be reimbursed.

IVF: dictionary of terms

We present the main terms that you may encounter while studying the topic of IVF and infertility treatment.

Assisted hatching: what is it?

Modern technologies make in vitro fertilization as effective as possible.

proivf.ru

Is it possible to do IVF with uterine fibroids?

Is it possible to do IVF procedure for uterine fibroids? This question is often asked by women dreaming of a child. According to numerous studies, uterine fibroids have not proven to be malignant tumor and this is 100% true. However, you should not relax, despite the fact that this anomaly is benign, it still remains dangerous, especially during a procedure such as IVF. Unfortunately, uterine fibroids today most often occur in young women. If, for example, fifteen years ago this pathology could occur in women after forty years of age, now it affects young girls from 23 to 34 years old, and sometimes even earlier.

Is it possible to perform IVF with such a pathology as uterine fibroids?

For what reason uterine fibroids appear, doctors still find it difficult to answer. Probably, many factors influence this, such as ecology, poor heredity, changes in hormonal levels, stress, and sun abuse.

But the result is always the same - uterine fibroids require constant monitoring, especially during pregnancy, since against the background of changes in hormones the tumor can increase in size. Naturally, this can prevent the fetus from developing properly, and if uterine fibroids completely deform it, then the woman most likely will not undergo IVF. Since the deviation will seriously impede the process of embryo implantation.

What to do in this case, you ask? The answer is clearly one - you should definitely systematically visit a gynecologist and conduct an ultrasound. The sooner the pathology is identified, the easier it will be to cope with it. When the disease is too advanced, doctors decide to remove the tumor along with the reproductive organ, so the problem must be solved as soon as it appears. While the tumor is small, it can be easily removed by laparoscopy. And already three months after the surgical intervention, the patient can plan a child.

Chances of conceiving and having a child:

Myomatous formations that do not deform the vagina, approximately 2–3 cm in size. Such a neoplasm has absolutely no effect on the IVF process. The rate of long-awaited pregnancy on the first try is approximately 38% (patient reviews confirm this). These data allow the procedure to be used for this form of fibroma without surgical intervention.
The incidence of pregnancy after the myomectopy method (this technique uses special punctures that stimulate rapid ovulation), the result of conceiving a child is 36%, with short punctures the figure is slightly lower - 23%. These IVF procedure success rates go so far as to allow patients to undergo IVF without prior surgery.
Uterine fibroids are located directly in the muscular part of the reproductive organ and increase its size. This state of affairs significantly reduces the possibility of carrying out the IVF procedure. Uterine pregnancy occurs on the first try in only 12% of women. In addition, with this form of the disease, often, even if a girl manages to get pregnant, she is subsequently unable to bear the fruit and a spontaneous miscarriage occurs. Thus, it turns out that before the IVF procedure, doctors first perform surgery to remove the tumor. Well, and then after drug treatment You can try to conceive again.
If a woman has passed conservative method myomectomy, then it is better to postpone the IVF procedure for a year, since after this period of time the risk of fibroids occurring again increases. Such a relapse will have a very adverse effect on the future procedure for conception; it simply reduces its effectiveness. And even if the doctor decides to use long stimulation punctures, this may not help, and you will waste your time, effort and money.

Typically, fibroids begin to increase in size when the patient is in " interesting position“, this in turn greatly interferes with the fetus’s development and growth. And if the fibroid has changed before the onset of pregnancy? reproductive organ, then it is simply impossible for a woman to undergo in vitro fertilization, since the fibroid will interfere with the process of introducing the embryo.

In order to protect yourself from this problem, you need to visit a gynecologist at least once a year and perform an ultrasound, because the sooner the pathology is identified, the easier it will be to cope with it, and there will be no need to undergo surgery. When the disease is already very advanced, doctors have no choice but to simply remove the tumor along with part of the uterus, which naturally will lead to the fact that the woman will never be able to have her own children.

While the tumor small size it's easy to fix special method called laparoscopy, after which the girl can count on conceiving a child three months after treatment.

To date, the connection between pregnancy and fibroids has not been fully substantiated, but it is clear that in some cases it can interfere.

According to statistics, it was found that 50% of women who were diagnosed with infertility due to fibroids and who subsequently underwent its eradication by surgery were still able to become pregnant and give birth to a child. This suggests that the neoplasm itself does not interfere with the process of implantation of the embryo.

The main reason counts:

Pathological changes in the endometrium;
Directly the deformation of the uterus itself.

Thus, as a result of long-term studies, it was found that a benign neoplasm with a diameter of less than seven centimeters does not deform the reproductive organ and does not in any way affect the onset of a long-awaited pregnancy.

From the above, you should understand that in vitro fertilization can be done, but treatment is also necessary.

How to increase your chances of having a baby?

As a rule, women who have been diagnosed with fibroids for many years have abnormal hormonal levels, weak immunity. Unfortunately, such patients are not able to conceive a child on their own. Whether surgical intervention is necessary or not depends on the severity of the pathology and concomitant diseases.

Most often, if surgery is unavoidable, doctors try to preserve the reproductive organ by all means. This is especially important if the patient plans to have children in the future.

However, it should be remembered that nodes may return again after surgery. Therefore, experts in the field of gynecology recommend systematically checking with a gynecologist for the presence of this disease.

Many women are concerned about the question: do they need to somehow prepare for conceiving a child if they have fibroids? The answer is clear: we recommend that patients between eighteen and thirty-five years old prepare for this happy event, as soon as the pathology was diagnosed. After all, it is extremely important to set up a favorable immune and hormonal background.

When several pathologies affecting infertility are combined at once (chronic inflammation, male infertility, the presence of endometriosis, nodes), with such problems, you definitely won’t be able to get pregnant on your own.

For medical reasons, doctors carry out special preparation for conception in such patients, using the method of in vitro fertilization.

The onset of the long-awaited conception of a baby with this diagnosis is approximately 31% under the age of 32 years. But at the same time, patients at this age and with such a diagnosis have a greater risk of losing their baby.

Scientists, during a long and scrupulous study of an egg with a neoplasm, noticed a decrease in the ability to fertilize on its own. Helping the body give birth to a new little life, many clinics use the hardiest spermatozoa ICSI MAX. This is necessary in order to select the best embryos to increase the chances of embryo survival. In some cases, the blastocyte is unable to hatch on its own, causing the embryo to fail and fail to develop normally. Technology does not stand still and today there are specialists (embryologists) who help the embryo free itself from the membrane.

To summarize, I would like to say that without the help of doctors it is almost impossible to solve the problem of conception with such a disease. This needs to be understood and should not be feared. If you want to have children, you must visit a gynecologist in a timely manner and get tested. If fibroids have been identified, there is no point in starting it, but rather pull yourself together and start treatment. Yes, it is very difficult and sometimes there is not enough time, but you cannot postpone treatment until later, as “later” may not come. As mentioned above, this is a benign neoplasm, but if this disease is neglected, everything can end very sadly. Being left without children is not the best dire consequences of this pathology, without treatment you can lose your life, since under some conditions myomatous nodes can turn into cancer and we must not forget about this!

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IVF and surrogacy for uterine fibroids

Uterine fibroids are the most common benign tumor of the female reproductive system. The prevalence of this pathology is extremely high - about 20% of women of reproductive age suffer from uterine fibroids.

Uterine fibroids and IVF

The tactics for monitoring and treating fibroids before starting an IVF program depends on the number and size of myomatous nodes, as well as their location relative to the uterine cavity.

Numerous studies have found that fibromatous nodes up to 3 centimeters in size, which do not deform the uterine cavity, do not affect the IVF program. Therefore, in the presence of interstitial and interstitiosubserous myomatous nodes of small size that do not deform the uterine cavity, surgical treatment before the program is not indicated.

Interstitial and interstitial subserous myomatous nodes of large sizes, myomatous nodes that deform the uterine cavity are subject to surgical treatment.

Depending on the size, number and location of nodes, the method of choice for surgical treatment is conservative myomectomy by laparoscopic or laparotomy.

If there are contraindications to surgical treatment, a good alternative for preparing patients with fibroids for the IVF program is uterine artery embolization (UAE)

Uterine fibroids and surrogacy

In the presence of uterine fibroids, there are no clearly established indications for an IVF program involving a surrogate mother. As a rule, a surrogate mother is involved in the program for the following indications:

large uterine fibroids, without the possibility of corrective treatment
uterine fibroids with severe deformation of the cavity, without the possibility of corrective treatment
cicatricial deformation of the uterine cavity after surgical interventions
failure of the uterine scar after removal of myomatous nodes
synechia of the uterine cavity after surgery.

How can pregnancy affect uterine fibroids?

When pregnancy occurs, under the influence of changed hormonal levels, dynamics in the growth of myomatous nodes may be observed. It has been noted that large myomatous nodes tend to grow, while the growth of small nodes (up to 5 cm) in most cases stabilizes. According to numerous studies, about half of the nodes up to 5 cm, detected before pregnancy, were not detected on ultrasound after childbirth.

What complications can occur during pregnancy if you have uterine fibroids?

risk of threatened miscarriage in the first and second trimesters, premature birth in the third trimester of pregnancy;

development of fetoplacental insufficiency
deterioration of blood circulation of the myomatous node up to its necrosis
premature placental abruption
early and late postpartum bleeding
development of labor anomalies during childbirth, uterine rupture along the scar;
premature rupture of membranes
thrombotic complications.

As a rule, uterine fibroids are not a contraindication to vaginal delivery. Surgical delivery is indicated in the presence of necrotic changes in the myomatous nodes, complicated pregnancy, atypical location of the nodes (for example, if the myomatous node is located low and disrupts the process of the fetus passing through the mother’s birth canal). After undergoing a conservative myomectomy, the decision on the method of delivery is always made strictly individually.

M.A. Bragina, gynecologist-reproductologist at Nova Clinic

nova-clinic.ru

2018 Blog about women's health.

Is it possible to do IVF procedure for uterine fibroids? This question is often asked by women dreaming of a child. According to numerous studies, uterine fibroids have shown themselves to be a non-malignant tumor and this is 100% true. However, you should not relax, despite the fact that this anomaly is benign, it still remains dangerous, especially during a procedure such as IVF. Unfortunately, uterine fibroids today most often occur in young women. If, for example, fifteen years ago this pathology could occur in women after forty years of age, now it affects young girls from 23 to 34 years old, and sometimes even earlier.

Is it possible to perform IVF with such a pathology as uterine fibroids?

But the result is always the same - uterine fibroids require constant monitoring, especially during pregnancy, since against the background of changes in hormones the tumor can increase in size. Naturally, this can prevent the fetus from developing properly, and if uterine fibroids completely deform it, then the woman most likely will not undergo IVF. Since the deviation will seriously impede the process of embryo implantation.

Chances of conceiving and having a child:

Myomatous formations that do not deform the vagina, approximately 2–3 cm in size. Such a neoplasm has absolutely no effect on the IVF process. The rate of long-awaited pregnancy on the first try is approximately 38% (patient reviews confirm this). These data allow the procedure to be used for this form of fibroma without surgical intervention.
The incidence of pregnancy after the myomectopy method (this technique uses special punctures that stimulate rapid ovulation), the result of conceiving a child is 36%, with short punctures the figure is slightly lower - 23%. These IVF procedure success rates go so far as to allow patients to undergo IVF without prior surgery.
Uterine fibroids are located directly in the muscular part of the reproductive organ and increase its size. This state of affairs significantly reduces the possibility of carrying out the IVF procedure. Intrauterine pregnancy occurs on the first try in only 12% of women. In addition, with this form of the disease, often, even if a girl manages to get pregnant, she is subsequently unable to bear the fruit and a spontaneous miscarriage occurs. Thus, it turns out that before the IVF procedure, doctors first perform surgery to remove the tumor. Well, and only then, after drug treatment, you can try again to conceive a child.
If a woman has undergone a conservative method of myomectomy, then it is better to postpone the IVF procedure for a year, since after this period of time the risk of fibroids occurring again increases. Such a relapse will have a very adverse effect on the future procedure for conception; it simply reduces its effectiveness. And even if the doctor decides to use long stimulation punctures, this may not help, and you will waste your time, effort and money.

Note to women who have had fibroids confirmed

Typically, fibroma begins to increase in size when the patient is in an “interesting position”; this, in turn, greatly interferes with the development and growth of the fetus. And if the fibroma has changed the reproductive organ even before the onset of pregnancy, then it is simply impossible for the woman to undergo in vitro fertilization, since the fibroma will interfere with the process of introducing the embryo.

While the tumor is small, it can be easily eliminated using a special method called laparoscopy, after which the girl can count on conceiving a child three months after treatment.

To date, the connection between pregnancy and fibroids has not been fully substantiated, but it is clear that in some cases it can interfere.

The main reason is considered to be:

Pathological changes in the endometrium;
Directly the deformation of the uterus itself.

From the above, you should understand that in vitro fertilization can be done, but treatment is also necessary.

As a rule, women who have been diagnosed with fibroids for many years have improperly functioning hormonal levels and weak immunity. Unfortunately, such patients are not able to conceive a child on their own. Whether surgical intervention is necessary or not depends on the severity of the pathology and concomitant diseases.

Most often, if surgery is unavoidable, doctors try to preserve the reproductive organ by all means. This is especially important if the patient plans to have children in the future.

Many women are concerned about the question: do they need to somehow prepare for conceiving a child if they have fibroids? The answer is clear: we recommend that patients between eighteen and thirty-five years old prepare for this happy event as soon as the pathology is diagnosed. After all, it is extremely important to set up a favorable immune and hormonal background.

If several pathologies affecting infertility are combined at once (chronic inflammation, male infertility, the presence of endometriosis, nodes), with such problems it will definitely not be possible to get pregnant on your own.

For medical reasons, doctors carry out special preparation for conception in such patients, using the method of in vitro fertilization.

To summarize, I would like to say that without the help of doctors it is almost impossible to solve the problem of conception with such a disease. This needs to be understood and should not be feared. If you want to have children, you must visit a gynecologist in a timely manner and get tested. If fibroids have been identified, there is no point in starting it, but rather pull yourself together and start treatment. Yes, it is very difficult and sometimes there is not enough time, but you cannot postpone treatment until later, as “later” may not come. As mentioned above, this is a benign neoplasm, but if this disease is neglected, everything can end very sadly. Being left without children is not the worst consequence of this pathology; without treatment, you can lose your life, since under some conditions myomatous nodes can turn into cancer and we must not forget about this!