Text on screen Fertility Authority. Your Most Trusted Source Ask the Experts How are fibroids diagnosed and treated Dr. Jenna McCarthy, South Florida Institute for Reproductive Medicine Most of the time, fibroids are initially diagnosed on ultrasound. And then they can be definitively diagnosed from a fertility standpoint by either a saline infusion sonogram, or an HSG. If the fibroid is well away from the cavity, and it's not changing the shape of the cavity at all, and it's not causing you any other symptoms, there's no reason you need to have it taken out.
So, doctors typically will recommend that you have the fibroid taken out if it's changing the shape of the cavity, or if it's causing some of the other symptoms. Fibroids are typically removed one of two ways. You can either have them removed by having a surgery, either laparoscopically or an open surgery where they make an incision in the belly, and have the fibroids removed. Alternatively, fibroids that are completely within the cavity can sometimes be removed vaginally. It depends on where the fibroid is. So, let's start with a large fibroid that's large enough that it's changing the shape of the cavity.
That type of fibroid might be removed laparoscopically, which is a couple of small incisions on the belly, nothing big. The procedure is usually performed as an outpatient procedure, which means that you can go home the same day, sleep in your own bed, take your pain medicines yourself, instead of having to be in the hospital. The healing time from that is typically two to six weeks, depending on the woman and how active she is. And then we usually ask you to wait three months before trying to get pregnant.
Some doctors will err on the side of caution and say as much as six months before trying to get pregnant. And then, typically, if the fibroid that was removed was large enough that we actually went all the way through the wall of the uterus to take it out, we'll recommend a csection for delivery, to help prevent the chance that the scar that's left in its place doesn't pop open during labor. The other way to remove fibroids is hysteroscopically, or vaginally. Those are fibroids that are completely within the cavity.
So, basically, they can put a little camera inside the uterus and look around you can see the whole fibroid. Those, the recovery time is even faster. The surgery itself, again, is outpatient. You go home the same day. The pain is much, much less associated with it. Most women are back to work within a week to two weeks. Some women don't even need that much time. And we usually don't ask you to wait more than one normal period before you try and get pregnant. And neither of the two surgeries make it so that you can or cannot have fertility treatments.
Some gynecologists are extremely skilled at removing fibroids. Other gynecologists prefer to refer those patients to either a reproductive endocrinologist or a minimally invasive surgeon. The advantage to doing that is most REs and minimally invasive surgeons are trained in doing laparoscopic myomectomies. The difference between a laparoscopic myomectomy and an abdominal myomectomy is the recovery time. With a laparoscopic, most women, really, are up and around and doing for themselves in about two weeks. It may be six weeks before they feel 100 percent, but they're usually at 80 percent or better by two weeks.
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