What are uterine fibroids?

Fibroids are benign tumors made of smooth muscle cells and fibrous connective tissue. They develop in the uterus. It is estimated that 70-80% of women will develop fibroids in their lifetime—however, not everyone will develop symptoms or require treatment. The most important characteristic of fibroids is that they are not cancer, and they do not have the potential to become cancer. Studies show us that fibroids grow at different rates, even in the same woman, and can range from the size of a pea to the size of a watermelon.

What causes uterine fibroid tumors?

The cause of uterine fibroids is not known, although studies demonstrate there may be a genetic component. There is no food or external exposure that a woman can have that can cause her to develop fibroids.

Who is at risk for uterine fibroids?

As women age their likelihood for developing fibroids increases. Studies have demonstrated that women with a family history are more likely to develop fibroids. Fibroids are also more common in African American women. Obesity has also been linked to an increase risk of fibroids. There are no foods or diets that are known to increase a woman’s risk of developing fibroids.

What are the symptoms of uterine fibroids?

Most women with fibroids will experience no symptoms at all. However, for many women large or numerous fibroids can cause the following symptoms:

>> Heavy or prolonged periods
>> Bleeding between periods
>> Pelvic pain and pressure
>> Frequent urination
>> Low back pain
>> Pain during intercourse
>> Difficulty getting pregnant

How are uterine fibroids diagnosed?

Fibroids are most often found during the physical exam. Your healthcare provider may feel a firm, irregular pelvic mass during an abdominal or pelvic exam.

Other tests may include:

– Transvaginal ultrasound. This is an ultrasound performed inside the vagina to better assess if you have fibroids. It can help establish the diagnosis as the first imaging test.
MRI. This imaging test does not use radiation, and allows your provider to gain a road map as to the size, number, and location of each of your fibroids. It is often recommended before proceeding with some surgical options.
Saline Sonohysteragram. This is a vaginal ultrasound performed in the office while putting fluid (saline) into the uterus. By expanding the uterine cavity with this fluid your provider may be able to see if you have fibroids growing within the uterine cavity.
Hysteroscopy. This is a surgical procedure performed to gain direct visualization of the uterine cavity. It does not visualize or treat fibroids outside the cavity.

How are uterine fibroids treated?

Since most fibroids stop growing or may even shrink as you approach menopause, your healthcare provider may simply suggest “watchful waiting.” With this approach, your healthcare provider monitors your symptoms carefully to be sure that there are no significant changes.

If your fibroids are large or cause significant symptoms, treatment may be an option. Treatment will be discussed with you by your healthcare provider based on your age, fertility goals, the number and size of your fibroids, any previous fibroids treatments, other health conditions.

What are the complications of uterine fibroids?

It is uncommon for fibroids to cause severe health consequences. However, women can have heavy bleeding which can lead to dangerous anemia. Rarely, large fibroids can press on the bladder and ureter, leading to kidney damage. Other complications include infertility and recurrent pregnancy loss.

Key points about uterine fibroids:
– Uterine fibroids are the most common tumor of the reproductive tract.
– Fibroids are not cancer.
– They do not increase a woman’s risk for uterine cancer, and they do not become cancer. 
– Women who are nearing menopause are at the greatest risk for fibroids. Fibroids are most often found during a routine pelvic exam.
– Symptoms may include heavy and prolonger periods, bleeding between periods and pelvic pain.
– Fibroids are most often found during a routine pelvic exam.
– There are a variety of treatment options available, which may include watchful waiting, medicines or surgery.

What is a cryocycle?

Cryocycle means usage of frozen embryos in repeated treatment cycles. In a treatment cycle like this, the multifollicular ovarian stimulation is not performed, and this leads to alower hormonal influence on the organism of the future mother. This significantly increases the chances for pregnancy onset.

Cryocycle is recommended in the following cases:
• after failed IVF attempt;
• if the couple already has plans for the second and third child while planning their first IVF;
• if there is a cancer condition and the upcoming treatment may affect further ability to reproduction;
• in the presence of diabetes mellitus or azoospermia in men.

The appliance of cryocycle has a number of advantages for the patient, namely:
• an opportunity to postpone the implantation of the embryo into the uterine cavity for the time needed for woman’s body to restore after hormonal hyperstimulation. By postponing the embryo transfer for a month or more, doctors are able to stabilize the hormones, therefore the probability of successful IVF program increases significantly;
• an opportunity to avoid one of the most dangerous complications of IVF program – multiple pregnancy. The development of multiple pregnancy has great risks for the successful pregnancy flow and the birth of healthy children;
• an opportunity to perform genetic diagnosis of the embryo using NGS method, which makes possible to identify embryos bearing chromosomal pathology and thus prevent failed IVF due to the natural ability of the uterus to reject an unhealthy embryo;
• reduction of financial costs of patients if the first IVF attempt failed – cryocycle allows avoiding repeated ovulation stimulation and using.

Inna Moroz, MD