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Fibroid Surgery or not?

Fibroid Surgery or not?

I am 39.5 and after 2 failed IVFs I will move to donor eggs.
I have a fibroid which in the past year has grown from 3cm to 5cm.
My doctor recommends surgery before moving to donor because my fibroid might affect implantation and cause miscarriage.
Surgery to remove the fibroid is a quite big surgery and there has to be a general surgeon together with my gynecologist just to make sure that I am opened correctly and because I have had 2 major surgeries in the stomach area years ago they have to be extra careful. Recovery time before moving to donor would be 8 months.
Today I went to see another specialist for a second opinion on the fibroid and I really got confused. He gave me a vaginal ultrasound and he basically said that if I were his wife he would recommend trying a donor egg cycle first and if that succeeds and results in a miscarriage I should then have the big surgery to remove the fibroid. He admitted that it is risky to have the fibroid and be pregnant and there is a good chance of miscarriage but he would take the risk with me. If a pregnancy is achieved and then I miscarry I can have the surgery then and then use the frozen embryos which hopefully I will have left.  
I am really confused dont know what to do because my standard doctor (who knows my uterus maybe more thoroughly) insists on me having the operation.
He also mentioned a 3rd option to take a medicine like lupron for 3 months just to see if the fibroid shrinks and then move to donor.
I would really appreciate your opinion on my situation.
Thank you for reading this.
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1278093_tn?1294323984
i had 3 fibroids removed in march prior to my first IVF.
i figured with all i had to go through with IVF including the cost, i wanted to maximize our chances.
got pregnant that first cycle and am 22 weeks today.
having been through 3 m/c i wouldn't do anything to increase that risk, since it is not an easy thing to go through.
good luck with your decision-mine was easier because they did mine via guided d&c rather than opening me up.
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1064785_tn?1331205894
I need to go through major surgery to remove my fibroid (it has to do with its location) and I need 8 months recovery time.
Sorry about your m/cs, did they have to do with fibroids?
Thank you
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134578_tn?1333922867
If you try the Lupron and it doesn't work, you've wasted three months.  Besides, if you get pregnant, the hormones are going to be back, and the fibroid might grow again.  Miscarriage is not a ho-hum event, and it would be heartbreaking to feel like you have wasted an embryo on something that could possibly have been avoided if you had gone ahead with the surgery first.  I'd opt for the surgery first, you do have time.
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922048_tn?1333937046
I agree with happynifer and Annie. I don't see any reason to waste an embryo. If the risk of m/c is high, then it doesn't seem like there's much point in going that route. That's a pretty long recovery time (8 months), but with donor eggs, your age isn't a factor any more so you have plenty of time.

One other thing. I realize you failed two IVF's. That must have been heartbreaking, not to mention expensive. But I was wondering if you had tried acupuncture to get your hormones balanced and improve egg quality? From all the research I've done, that seems to be the single most effective method for helping women with the dreaded high FSH/DOR diagnoses to be able to conceive with their own eggs. And I was just thinking that, since you're going to have 8 months on your hands while you're recovering, maybe trying something like acupuncture might enable you to use your own eggs once you're able to TTC again. Just a thought. Good luck! Keep us posted!
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1278093_tn?1294323984
it's hard to know the cause of an early m/c, but yes we think mine were due to the fibroids interfering with implanation.
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1064785_tn?1331205894
Thank you all for your comments and so precious advices.
My FSH is not very high but I am a very poor responder to drugs and most probably my eggs quality is not going to improve because I have done chemo in the past (3 times) and most probably my eggs were affected.
I just wanted to have a baby 'asap' possible and the idea of waiting for a whole 8 months to recover from the surgery is not so attractive.
When I did the 2 IVFs the fibroid was there but IVF drugs made it grow bigger.
I will have a serious talk with my main doctor tommorrow and if she is still insisting in me having the operation I will go on and have it.
I thought the decision to move to donor eggs was big and now this... and I have had 3 major operations in my life so far so I am not thrilled to have another one. But I guess this one will be for a very good reason.
Thank you all again, I will keep you posted and I wish you luck!
M xxxx
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134578_tn?1333922867
The last thing you want is for the hormones of pregnancy (which trump the hormones they give you in IVF) to make the fibroid grow during your pregnancy, and to cause a problem with it after it gets well started.  You've got a good decision going with the donor eggs, they give you time.  Don't jump on it half-ready and lose another good chance.  The expensive thing here is not time, it is the embryos, they are the limiting factor as you are really still plenty young enough.  Try to be patient, get the surgery, and then go forward with your pregnancy knowing you did everything you could to support that embryo.  

Good luck!!

Annie
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1419915_tn?1289260700
ps.  i discussed this with my husband who is a doctor and mentioned the possible risk of scarring which can also interfere with pregnancy.  you can ask your long-term doctor about this too should you decide to go with the surgery first.  this is not to say that you will have scarring... it is not uncommon to have fibroid removal then have a successful pregnancy, but we are all different and our bodies are different, so its best to ask your doctor.
good luck :)
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1064785_tn?1331205894
Thank you so much for your answer.
I really am very confused on what to do.
If I move with the donor and dont succeed I will lose my money and know for sure that I have to do the operation. Hopefully, I will have some embryos left for FET.
If I get pregnant and then miscarry I will be devasted I am sure.
I dont know if I am ready for a big operation though (have had colectomy which was really a big thing so this should be easier).
Another thing that confused me more today is that the one doctor said we need to have a general surgeon together with the gynecologist and the other one (my long term doctor) said we would just have another gynecologist's help (already in the clinic). Maybe I should get a general surgeon's opinion also?

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1419915_tn?1289260700
my husband said (who is also a surgeon) this is best done with another gen surgeon along with your long term doctor.  some REs can do this too depending on their experience.  i had a polypectomy done by an RE from brigham womens in boston.  i wasn't going to do it with any other doctor.
i know it is so confusing and you feel that your are raising against time and money.  i was faced with this confusing situation when i found out i had polyps (one the size of my uterus) and my re said it would definitely get in the way of getting pregnant.  i didn't want to have the surgery if i can help it b/c of the risk of scarring but b/c it was as big as my uterus, there was no other way to go around it than have it removed.  it was a set back in getting pregnant given my age ... it was tough.
i read one of previous comment here where she said since it is a donor egg, you still have time... there is no real urgency to get pregnant unlike using your own egg where every month that passes by means your own egg getting older by a factor of 5-10yrs.  so if you are concerned about the expense... maybe wait... relax.... take your time deciding (not too long though :)) ) and then perhaps go with the surgery so you know you've given yourself the most chance of getting pregnant and should the pregnancy doesn't happen in-spite of having the fibroid removed, at least you know you've done your best and its just a matter of tweaking your hormones.  :)))
hang in there.
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