Surgery for fibroids? Fibromyomas, the technical name for fibroids, are common in women of childbearing age, especially as they get older. As many as 40 percent of women by the age of forty have these begin muscle tumors. In nonpregnant women, fibroids may cause excessively heavy periods and discomfortable from pressure. But in pregnancy they are in fact not a major cause of miscarriage, and a doctor would not terminate a pregnancy just because of small fibroids.

As mentioned earlier, fibroids can occur in different parts of the uterus and the uterine wall. What has emerged as a fairly common problem these days is that women in their late thirties havee had time to develop fibroids, sometimes as big as a large melon. In the nonpregnant state this could make you look as though you were 5 months pregnant! The question then is whether you should get pregnant with the fibroids, or have them removed first.

My feeling is that it is probably best for you to undertake a pregnancy first—and  see what happens. This may sound cruel, especially after all my previous comments about the trauma of a miscarriage. But, you may not miscarry even with the fibroids, in which case you will have discovered to your fortune that the fibroids were not a problem. Should you, unfortunately, miscarry—at least you know that surgery for removal of the fibroids, a myomectomy, is probably necessary. It is not an operation ever to be undertaken lightly, as removing large multiple firoids might have a severely scarred uterus. This scarring could even affect your fertility. Also, if during removal of fibroids, the cavity of the uterus is entered, a C-section delivery will be needed in your next pregnancy to avoid uterine rupture.

This is why I feel it is better to try a pregnancy first, before undertaking any surgery, unless your doctor advises otherwise in your particular case. Fibroids may soften during pregnancy. That process might cause some pain and occasionally a low grade fever, but it can be overcome with bed rest and a mild painkiller such as Tylenol.

Another potential problem with a large fibroid or fibroids is the implantation of the placenta over one of the tumors, which could cause premature labor. This is a treatable condition. Occasionally, very rarely, a fibroid obstructs the pelvic outlet, and you might need to be delivered by C-section.

Fibroids also should not be removed from the uterus during a pregnancy or at the time of a C-section, as the procedure may be accompanied by severe hemorrhage. However, you must leave this decision to your obstetrician.