Infertility and Fibroids – informed decision making

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?

So what is your dream weight? Size zero? Or would you like a big bosom and huge buttocks like the old time film stars. Fashions are a dictate of the society that you live in. Beauty is a creation of the human mind. But did you know that that both ‘thin’ and ‘fat’ impair fertility? Let’s look at it a little scientifically.

We all know that an egg is released around the 12th to 14th day of the menstrual cycle. The time from the egg release or ovulation to the next oncoming period is relatively fixed at 14 days. If ovulation is delayed by, say, one week, the next period will also be delayed by a week. And what if ovulation does not occur at all – then the next period will be delayed and irregular. Both, the delay and absence of ovulation impair fertility. The factors that could cause this are – excessive weight, too thin, excessive eating, excessive starvation, excessive exercise, too sedentary – are you getting it? It is the extreme of anything and you could land up as infertile.

Q 1 – Can my husband also be responsible for me not having a baby?
Not being able to have a baby is called infertility and it is as much a responsibility of the husband as the wife. In fact, one third of the cases infertility are due to problems in you, the female partner, and in one third only your husband is responsible. In the rest of the one third there may be problems in both the partners. The husband should have his semen analysed where the number, movement, quality and appearance of his sperms are tested. This should be done early so that invasive and expensive testing of the wife can be prevented. Further testing may also be required. Remember that any medicines given to the husband will improve the sperms 3 months later since the immature sperms spend that time in those tortuous tubules before ejaculation.

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For pregnancy to occur, the entire system has to work perfectly – egg has to release; it is picked up by the fallopian tube where it meets the sperm which has wriggled its way up from the vagina; the fertilized egg then re-enters uterus where it grows to a full sized baby. Problems can occur anywhere in this system causing infertility. Medicines can help when hormonal problems prevent pregnancy. However, there are many cases where relief can only be obtained by surgery. These are known as Fertility Enhancing Surgeries and are best by a hysteroscopist – gynaec  laparoscopist surgeon. These are minimal access surgeries and are extremely fascinating in what they can achieve with least discomfort to the patient and maximum results.

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