Dhakshnamoorthy J.
· Google
Each and every steps were observed & performed by the main doctor, Dr. Vani mam itself.
Home › Conditions › Uterine problems
CONDITIONS · FIBROIDS, POLYPS AND THE WOMB
Fibroids, polyps and scarring: where they sit matters more than their size.
Growths and changes in the womb are common, and most never affect a pregnancy. The ones that matter are usually those that change the lining where an embryo implants.
- Very common, often no symptoms
- Found with a scan
- Many need no surgery
- Cavity problems fixed by hysteroscopy
- Submucosal fibroid — Bulges into the cavity. Most likely to affect implantation
- Intramural fibroid — Inside the muscle wall. Matters if large or pressing on the cavity
- Subserosal fibroid — On the outer surface. Rarely affects fertility
- Polyp or scar tissue — In the lining. Removed at hysteroscopy
Urgent: same-day care
Bleeding heavily and feeling faint? Get help today.
- Call us the same day if you are soaking a pad every hour, passing large clots, or feel dizzy, breathless or faint. After any womb procedure, severe pain, fever or smelly discharge also needs a same-day call. Outside clinic hours, call 108 or go to the nearest emergency department, then call us on +91 89399 94244.
01Which uterine problems affect fertility?
Fibroids, polyps, scarring inside the womb, adenomyosis and a septum can all affect fertility, mainly when they change the cavity where the embryo implants.
Fibroids are non-cancerous muscle growths. Polyps are small overgrowths of the lining. Scarring (adhesions, or Asherman syndrome) can follow a D&C, infection or surgery. Adenomyosis is womb lining growing into the muscle wall, a close cousin of endometriosis. A septum is a band of tissue dividing the cavity, present from birth.
02Do fibroids affect pregnancy?
It depends on where they sit: fibroids that bulge into the cavity can lower the chance of pregnancy, while most in the wall or on the outside do not.
Fibroids inside the cavity (submucosal) can get in the way of implantation and are usually removed. Fibroids in the wall (intramural) matter mainly when large or pressing on the cavity, and the evidence for removing them is uncertain. Fibroids on the outside (subserosal) rarely affect fertility. In pregnancy, fibroids can cause pain, and your obstetrician should know about them.
Honest note
Many fibroids need no surgery before trying. Removing fibroids that do not touch the cavity has not been shown to improve the chance of pregnancy, and surgery costs recovery time. (What the evidence says (ASRM guideline))
03How are uterine problems found?
A transvaginal ultrasound finds most of them; a saline scan, HyCoSy or hysteroscopy shows the inside of the cavity clearly.
A 3D scan helps map fibroids and show the shape of the cavity. Hysteroscopy, a thin camera passed through the cervix, lets us see and often treat in the same sitting. MRI is used when there are many fibroids or adenomyosis needs mapping before surgery.
Hysteroscopy at Jananam04How are fibroids, polyps and scarring treated?
Problems inside the cavity (polyps, submucosal fibroids, scarring, a septum) are usually treated by hysteroscopy, with no cut on the tummy.
Larger fibroids in the wall are removed (myomectomy) only when they distort the cavity or cause heavy bleeding or pain, and you then wait a few months before trying. Adenomyosis is rarely operated on for fertility; hormone treatment before a frozen embryo transfer is sometimes used, though the evidence is limited. Whether to cut a septum is decided case by case, because trials have not shown a clear benefit for everyone.
05When should a uterine problem be left alone?
When it is outside the cavity, causes no symptoms and is not large, the right plan is usually to leave it and get on with trying or treatment.
Delaying IVF for an operation that will not change your chances costs you time. If heavy periods have left you anaemic, that is treated first, because it matters for pregnancy too. Fibroids can grow over time, so we recheck with a scan before any transfer.
Does this sound like you?
Do any of these sound like you?
- A fibroid or polyp seen on my scan
- Heavy periods, or bleeding between periods
- Periods became very light after a D&C
- Told I have adenomyosis or a bulky uterus
- Good embryos, but no pregnancy after transfer
- More than one miscarriage
More than one miscarriage? The womb is one of several causes worth checking.
The order we decide in.
- 1
Map it
Where each fibroid or polyp sits, how big it is, and whether it touches the cavity. Plus both partners' basic tests.
- 2
Leave it, if it won't matter
Outside the cavity, no symptoms, not large: we leave it and plan your treatment around it.
- 3
Hysteroscopy for the cavity
Polyps, submucosal fibroids, scarring and some septa removed through the cervix.
- 4
Surgery for a few
Myomectomy for large fibroids that distort the cavity or cause heavy bleeding. [CONFIRM: done at Jananam or referred]
- 5
IVF or frozen transfer, planned around the womb
When other factors need IVF, the lining is prepared and checked on a scan before the transfer.
Your first visit
1
Talk
Your periods, any bleeding between them, past D&C or surgery, miscarriages and how long you've tried.
2
Test
A detailed transvaginal scan, a saline scan or hysteroscopy if the cavity needs a closer look, and his semen analysis.
3
Plan
Which findings matter, which to leave alone, and whether anything should be fixed before you try.
4
Treat
Hysteroscopy if needed, then trying naturally, IUI or IVF, whichever your other results point to.
Questions patients ask
Still unsure? Ask us on WhatsApp — a real person replies.
Can I get pregnant with fibroids?
Yes, many women with fibroids get pregnant without any treatment. Fibroids mainly lower the chance when they bulge into the womb cavity, and those can usually be removed by hysteroscopy.
Do fibroids need to be removed before IVF?
Only some do: fibroids that distort the cavity are usually removed first, while most fibroids in the wall or on the outside are left alone. The decision rests on where the fibroid sits, not just its size.
Can a uterine polyp cause infertility?
A polyp can get in the way of implantation, especially if it is large or near the tubes. Removing it at hysteroscopy is quick, and trying can usually resume soon after.
Does adenomyosis affect fertility?
Adenomyosis can lower the chance of implantation and raise the chance of miscarriage, but many women with it do conceive. Treatment is planned around it rather than by surgery in most cases.
Where can I get hysteroscopy for infertility in Chennai?
Jananam Fertility Centre does hysteroscopy at its Neelankarai hospital in Chennai, after a scan shows it is needed. [CONFIRM: day care, anaesthesia or sedation, time at the clinic]
How long after fibroid surgery can I try for a baby?
After hysteroscopy for a polyp or small fibroid, usually within a cycle or two; after a myomectomy through the tummy, usually a few months. Your surgeon sets the exact wait, and may advise a caesarean for delivery after a major myomectomy.
In their words, not ours.
Kishore K.
· Google
It felt less like a medical facility and more like a place of hope.
CONDITION
Endometriosis
Adenomyosis's close cousin, and how it affects fertility.
TESTHysteroscopy
A camera look inside the womb, often treating in the same sitting.
TREATMENTFrozen embryo transfer
How the womb lining is prepared before a transfer.
TREATMENTTREATMENT · When other factors need it, planned around the womb.
When other factors need it, planned around the womb.
Before anyone operates, ask if it will help.
Send us your scan report and how long you've been trying. A real person from Dr Vani's team replies on WhatsApp, usually within minutes during clinic hours (Mon to Sat, 9am to 5pm. Sunday closed.).