What Are Uterine Fibroids?
Uterine fibroids (leiomyomas or myomas) are non-cancerous growths that develop from the smooth muscle tissue of the uterus. They range in size from a few millimetres to several centimetres, and a single uterus can contain one or many fibroids. They are extremely common — up to 70–80% of women will develop at least one fibroid during their lifetime, though many remain asymptomatic.
Fibroids are classified by their location: submucosal (inside the uterine cavity), intramural (within the muscular wall), and subserosal (on the outer surface of the uterus). Their location, size, and number determine whether treatment is needed and which approach is most appropriate. Dr. Unnati Mamtora offers both medical and minimally invasive surgical options, with an emphasis on preserving the uterus and protecting future fertility.
Common Symptoms
- Heavy or prolonged menstrual bleeding
- Pelvic pressure or a sensation of fullness
- Frequent urination (from pressure on the bladder)
- Constipation or rectal pressure
- Lower back pain or pelvic pain
- Abdominal distension or visible enlargement
- Difficulty conceiving or recurrent miscarriage
- Anaemia due to heavy bleeding
Many fibroids cause no symptoms at all and are found incidentally on a pelvic ultrasound. Treatment is only necessary when fibroids are symptomatic or when they are affecting fertility.
How Fibroids Affect Fertility
The impact of fibroids on fertility depends largely on their location. Submucosal fibroids — those that bulge into the uterine cavity — consistently impair implantation and are associated with higher rates of miscarriage. Intramural fibroids that significantly distort the cavity can have a similar effect. Subserosal fibroids generally have a minimal impact on fertility unless very large.
Treatment (particularly myomectomy) has been shown to improve pregnancy rates in women with cavity-distorting fibroids. Dr. Unnati will assess fibroid location and size on ultrasound or MRI to determine whether surgical removal is warranted as part of a fertility plan.
Treatment Options
Medical Management
Hormonal medications (GnRH analogues, ulipristal acetate, progesterone-based therapies) can temporarily shrink fibroids and control heavy bleeding. Used to prepare for surgery, or to manage symptoms in women near menopause.
Laparoscopic Myomectomy
Keyhole surgery to remove intramural and subserosal fibroids while preserving the uterus. Offers faster recovery than open surgery, less blood loss, and minimal scarring. Dr. Unnati is highly experienced in this technique.
Hysteroscopic Resection
For submucosal fibroids within the uterine cavity, a hysteroscope (thin camera) inserted through the cervix allows the fibroid to be removed without any external incision. Recovery is rapid, typically 1–2 days.
Fertility Treatment Post-Removal
After myomectomy, most women can attempt natural conception within 3–6 months once the uterus has healed. Where fertility challenges persist, IVF or IUI may be recommended. Dr. Unnati coordinates the full fertility journey from surgery to conception.