Fibroid

Hello,

I've been diagnosed with Fibroids and they are all located outside of my cavity (3 large ones and some small ones but the biggest one is about 5 cm). My RE told me that I don't have to remove them since it won't interfere with my IVF cycle so I didn't and got pregnant with twins. Later, I lost the first one in 8 weeks and second one in 15. With the second one, my water just broke, I went to the hospital and they couldn't find the heartbeat. Later that day I passed the fetus by myself followed by a d&c. Now my RE suggest to have my fibroids removed and he possibly thinks that fibroids are the cause of my miscarriage. He's not sure since he can't find anything else and they couldn't test the fetus because of some reasons in the hospital so we don't know if it was chromosomal issue or not.

I'm really scared to do the myomectomy and I know it needs a long recovery. What do you usually suggest to your patients in a similar situation like mine? I know fibroids can cause miscarriage sometimes but what I don't understand is how come there was no heartbeat after my water broke (if fibroid caused the rupture) or maybe something was wrong with the placenta or the fetus.

I appreciate if I get any suggestions or answers.  

[Elaine Brown, MD]

Hi!
I'm sorry for your loss--it must have been devastating!
One possibility (there are many) that comes to mind is that the placenta of the baby/ies was inserted into the wall of the uterus underneath the fibroid, and that could have affected the blood supply to the fetus.  The loss of the heartbeat before the water broke suggests that something was wrong with the baby rather than a problem with your cervix.
It is common to lose one fetus early in a multiple pregnancy, so there may have been "no reason" that we can diagnose for the first loss.  The second loss is more likely to have been a chromosomal or uterine problem.
I'm sure that your RE would work with you either way--through another cycle with or without removing the fibroids.  Also, myomectomy can sometimes be done laparoscopically and that if often fairly easy.
Hope this helps!
Dr B