I am 32-years old and have been married for the past seven years. My husband and I have been unsuccessfully trying to conceive for five years.
I have had a series of tests to assess my fertility and the only unusual thing my doctor commented on was the presence of fibroids in my uterus. He said that they were relatively small and he wasn’t very keen on removing them. I want them out.
If there is nothing else wrong with my reproductive system, then why am I not conceiving? My husband has a child from a previous relationship so clearly, I am the one with the problem.
Shouldn’t my doctor remove the fibroids?
First, allow me to correct you. You are not the one with ‘the problem’. Infertility is a couples’ health problem, not the fault of an individual. Do not blame yourself for it.
Can fibroids really lead to infertility?
Uterine fibroids are the most common non-cancerous tumours (growths) in the womb. They are found in close to 50 per cent of women.
For most women, they often, however, do not give symptoms. For those in whom there is a problem, it is mainly related to abnormal uterine bleeding (usually heavy periods that last longer).
In some cases, fibroids can lead to problems with either conception or carrying a pregnancy to term or labour.
Size and number
Very large, multiple fibroids can make it difficult to carry a pregnancy to term. Small fibroids rarely cause problems.
Fibroids located at the junction where the fallopian tubes join the uterus can cause challenges with conception. Those located at the cervix (opening of the uterus) can cause challenges with both conception and childbirth.
How are fibroids treated?
There are three locally available management solutions for fibroids.
Surgery: They can be surgically removed in a procedure known as a myomectomy. Myomectomy is offered to women who wish to continue having children. The fibroids are removed whilst leaving the uterus intact. Older women who have achieved their desired family size are offered a hysterectomy (removal of the womb).
Embolisation: The blood supply to the fibroids can be cut off in a procedure known as ‘uterine artery embolisation’. Once the blood supply is cut off, the fibroid shrinks. The procedure is non-surgical. The doctor uses a special scanning machine to find the blood vessels supplying the uterus.
Hormonal therapy: Fibroids increase in size when stimulated by female reproductive hormones. If you block production of these hormones, the fibroids will shrink. Hormonal therapy, however, is not ideal for someone attempting to conceive.
Herbal solution: There is currently no herbal drug in the market that has been licensed for use in the treatment of infertility or fibroids by the Kenya Pharmacy and Poisons Board.
Surgery isn’t always the solution
Fibroid surgery comes with risks and sometimes the outcome is not what you expect.
In your case, if your doctor feels that the fibroids are too small to be cause of your infertility, then removing them will not lead to you being able to conceive.
You may end up incurring costs for an unnecessary procedure. Only fibroids that have been objectively assessed to be contributing to conception or pregnancy complications or abnormal uterine bleeding should be considered for surgery.
Your husband needs a check up
Talk to your husband about getting his fertility assessed. There are two reasons for this.
One, although it is an unpleasant thought to ponder, the child from the previous relationship may not be his biological offspring.
Two, it is possible for a man to sire one child and have problems siring more. This could follow an infection of the reproductive tract or sperm quality related issues.
It is crucial that he gets a proper assessment and do not just use the presence of a child from a previous relationship as a measure of fertility.
There are several ‘assisted conception’ clinics in Kenya (popularly known as ‘fertility clinics’). These clinics are specifically designed to help couples who are having challenges conceiving.
Speak to your doctor about accessing one of these clinics. During the initial consultation, the fertility clinic doctor will need to know what tests you have already done (talk to your gynaecologist about writing a comprehensive report about your situation.
This report should include relevant laboratory results and scans). They will then determine the best way to manage your case.
Be open to alternative motherhood
Always remember that you do not have to give birth to a child to become a mother. Consider adoption as a possible solution for you. There are several children’s homes in Kenya licensed to facilitate adoption. Usually, adoption can be undertaken once an infant is six months old.
Struggling to conceive can be very emotionally challenging for a couple. It can sometimes even push a couple apart instead of drawing them closer together.
It is often helpful to share your concerns with someone you trust. This can either be a professional counsellor or a spiritual guide or even another couple who understand what you are going through.