Q: I am a 37 years old woman who conceived last year but had 4-5 uterine fibroids, so I had an abortion in the fourth month of my pregnancy. After 2 months I underwent myomectomy. The doctor said that I could try for a baby after 6 months. Post-myomectomy scan results show normal uterus as well as normal ovaries. I have been getting my periods regularly. But I get premenstrual spotting for about a week before the actual menstrual bleeding. What are the chances of conceiving again? Is it true that myomectomy reduces the chances of a normal pregnancy? I weigh 48 kg and my height is 155 cm.

A:Not all fibroids affect a pregnancy adversely. Therefore not all of them need removing. However, depending on the location and size of the fibroid there is can be a role for myomectomy. The disadvantage of removing the fibroids, is that following their removal, one tends to develop adhesions in the pelvis i.e. tissues stick to each other during the process of healing and may occasionally lead to tubal block (meaning the fallopian tubes where the egg meets the sperm, can get blocked). However, this does not happen to all those who undergo the operation. The adhesions are less commonly seen with laparoscopic removal compared to an open method. It is difficult to quote your chances of conceiving (in numbers). The eventual outcome will depend on the location from where the fibroid was removed and the surgical technique employed. I do not think you need to get too disappointed if it has not been long after your operation. Unfortunately there is a small risk that the chances of conceiving may have gone down compared to those before your operation. Spotting before your periods is hormone related and usually settles down itself without any treatment. However if it persists or is bothering you, you may take cyclical hormones to regulate your cycles.