Do fibroids really cause infertility? DR NIRJA CHAWLA states the facts

The association between fibroids and infertility has been controversial. With advances in infertility management like fertility drugs, ART (Assisted Reproductive Technologies like IVF, ICSI) and advanced surgical techniques like hysteroscopic and laparoscopic myomectomy (removal of the fibroid), there is considerable interest in the commonly asked questions: Do fibroids really cause infertility and which fibroids would require myomectomy?

Fibroids are bundles of smooth muscle cells in the uterus forming benign tumours. Depending on their location they affect fertility in different ways. Those which are inside the cavity of the uterus are called polypoid/submucous fibroids depending on whether they hang with a stalk or not. Intramural fibroids lie totally within the walls of the uterus. Those arising from the outer surface of the uterus are subserous fibroids. An estimated 20 to 30 per cent women have fibroids during their reproductive years, more with increasing age. The current trend of delaying childbearing increases the chances of having fibroids. Most fibroids are detected because of the symptoms they may cause: excessive menstruation, pelvic pain and sensation of weight, pressure on the urinary system or rectum. All such fibroids will require treatment irrespective of their size, number and location. More fibroids, however, are asymptomatic, with no symptoms other than infertility or repeated abortions, and are picked up on routine ultrasound. Since the most essential information is whether there is distortion of the uterine cavity and the inability of simple ultrasound to give this information, hysteroscopy is a key diagnostic tool and the gold standard.

... contd.