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 (probably due to the IVF meds).
My doctor recommends surgery before moving to donor because my fibroid might affect implantation and also cause miscarriage. (The fibroid is inside the uterus, kind of hanging in the upper side).
Surgery to remove the fibroid is a quite big surgery (myomectomy) 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

[Elaine Brown, MD]

Hi!
I am so glad you are going to try the donor eggs!  You won't regret it for a minute, and you won't even remember that you did it once you hold your baby!

A couple of thoughts about the fibroid.  I personally don't think that I could go through a miscarriage--they can be SO devastating. I have had a patient who miscarried at 16 weeks because the placenta was right on top of the fibroid. The literature supports removing the fibroid, and suggests that it will improve your chances of conception as well as carrying the pregnancy to term.  There are also lots of nasty tricks fibroids can play during pregnancy--pain, contractions, preterm delivery, etc. OK, so my bias is for removal.

Having said that, I wonder about HOW to remove it.  I think the lupron is a good idea, because it might also make the fibroid easier to remove.  Could the fibroid be removed by the hysteroscope ( from inside the uterus?) rather than a laparotomy?

Also, there is a new technique called MRI assisted ultrasonic myomectomy.
The fibroids are destroyed with ultrasound waves and no surgery is required. You might ask your doctor about those two options as well.  

The best news about donor eggs is that you don't have to worry about the biological clock any more.

I hope everything works out well for you!
Good luck!
Dr B

[Keep_alive_kicking]

The type of my fibroid can only be removed via laparotomy.
I have researched MRI assisted ultrasonic myomectomy, I cannot have it in my country, it is quite expensive and it only shrinks the fibroids and NOT remove them. Also, it is suitable for women who do NOT wish to become pregnant in the future.