Fibroids
There are 3 different types of Fibroid which are golf ball shaped extra growths of muscle in the womb. Those inside the womb (1) distorting the lining and acting like a contraceptive coil, (2) Those in the muscle of the womb, and (3) those on the outside. Large fibroids can be a combination of 2 or 3 types. There is little doubt that those inside the womb reduce the chances of pregnancy, and increase the chances of miscarriage. There is also good evidence that those in the muscle have a similar effect. However those solely on the outside have less effect on fertility. It is possible to remove fibroids by a keyhole operation either from inside the womb (Hysteroscopy), or outside the womb, laparoscopy. If more than 4 exists then the keyhole operation will be time consuming and an open operation (laparotomy) may be simpler.
In a recent study, 106 women who had significant fibroids removed by a minimal access approach were compared with 106 women who had their fibroids untreated. The treated group had a 42% delivery rate as compared with 11% in the purely diagnostic group. {Reference Number 8}

