Qus & Ans: Fibroids

I am a 33 years old indian woman. I have some problems in getting pregnancy.I give my full details here and I want some suggestions from you.I married in Aug'1996. I conceived once but it had aborted after 60 days.On the 48th day, HSG was taken as the gravindex was negative. Follicular tests were good.Is there any solution for this fibroid? It it curable by taking medicines? Is there any latest special injections to make the fibroid to shrink? Will the injection or medicine give any harmful problems? Is it any necessary to undergo any operation? Will i be able to conceive if i have any medicine or injection? I am submitting the Doctor's report for your reference.

I would be very greatful to you if you give your valuable advice in this regard and also suggest me where I can get more details.

Dear Patient:

Thank you for your note that I read with interest. Unfortunately a submucosal fibroid is not sensitive to medical therapy such as Depot Lupron or progestogens (i.e., medroxy-progesterone acetate). Therefore the most reasonable approach would be performing a hysteroscopic resection of your fibroid.

That may not be sufficient to ensure a pregnancy. I see little data to reassure you that a complete diagnosis has been made. Although I don't have your complete clinical history, I understand that you don't have data to prove that your egg quality is adequate, to rule out a male factor as well as other significant factors that contribute to infertility. A myomectomy followed by protacted infertility can be a frustating experience that repeats itself just too many times throughout the country.

Before suggesting any testing, I would prefer to carefully review your medical records. If you can either mail or fax a copy to me (615-321-8877) I would really appreciate it. If you provide us with your home address we will forward a clinical questionnaire to complete your medical history. This will allow us to carefully outline the therapy with the highest success rate for you.

We must rule out any other factors if we expect a high success rate per treatment action (in our program there are only 1.2 treatment actions per birth, including patients up to age 44 using their own egg and 54 using egg donation).

If you want to discuss your infertility in greater detail or begin testing, please call us. If you want to arrange a telephone conference after hours, please call our front office.

Sincerely,

Jaime Vasquez, M.D.
Voice: (615) 321-8899 ~ FAX: (615) 321-8877

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