MRgFUS and Pregnancy - Questions and Answers
It is completely possible for a myoma to be the reason that stops a woman from getting pregnant. Myomas that are located close to the uterus especially can be the cause of infertility. It is also known that myomas can grow considerably during pregnancy. This can result in a premature or stillbirth. Myomas can also make the birth difficult if they block the birth canal due to their position. In this case, your doctor may recommend a Cesarean section. Myomas increase the risk of heavy bleeding after the birth and can prolong the time until your abdomen returns to its normal size.
If you should become pregnant despite having a myoma, you cannot have the myoma treated until the baby is born. Myomas are not generally removed during pregnancy. If your symptoms are still present after the birth of the baby, discuss your further treatment options with your gynecologist. Myomas do not necessarily prevent pregnancy, but they can cause problems during the pregnancy.
One major advantage of this treatment method is that the patient's fertility is left completely intact. MRgFUS treatment with the system from Insightec/GE is CE-certified for women of child-bearing age and is therefore approved throughout Europe. All in all, the fertility data available so far following MRgFUS treatment demonstrates a promising fertility rate and a lower number of Cesarean sections being required.
There are no figures or studies that can currently confirm that the procedure is better than a myomectomy (surgical removal of the myoma) in terms of fertility. However with MRgFUS, the wall of the uterus is not damaged, therefore the risk of the wall tearing under the strain of pregnancy is considerably reduced compared to surgery (wall scar formation). There is no risk of damaging the ovaries with MRgFUS.
Women should wait at least 2-3 months after MRgFUS treatment before trying to become pregnant. Contraception should be always be used after the treatment to ensure adequate healing.
After 6-9 months, the healing and shrinkage process in the area of the previously treated myoma is well advanced. Generally speaking, the volume is reduced by 60-70% by this stage. There is some soft residual tissue left over which is filled with connective tissue. There is usually some tissue left over in the uterus which corresponds to a connective tissue "scar", although this generally does not cause any problems whatsoever. The soft connective tissue allows the uterus to expand during pregnancy without risking the wall of the uterus tearing.