Should you freeze your eggs before you have your fibroids removed?

The American Society for Reproductive Medicine has just declared that freezing your eggs prior to egg-destroying cancer treatments is no longer considered experimental.  However, they did not recommend that all women bank eggs for the future in case the right time to have a baby happens after their eggs are too old.

As a fertility specialist who uses frozen eggs on a regular basis to help women conceive, I recommend that some women with fibroids should consider freezing their eggs before they have their fibroids removed (myomectomy).  Fibroids are very common in women in their child-bearing years.  They can affect up to 30% or more of women in this age group.  Many fibroids do not cause problems, but when they do, they can profoundly affect a woman’s health and her chances of having children.

Fibroids do not directly cause infertility but may impact fertility by causing a lot of heavy, irregular bleeding or by causing blocked tubes or an abnormal uterine cavity.  The issue is that taking fibroids out may not improve fertility and in fact, can often cause infertility by creating scar tissue that leads to blocked fallopian tubes or by affecting pelvic blood flow, which, in turn, may affect ovarian function.  In extreme cases, sometimes large fibroids must be removed to resolve unbearable symptoms, but may not be able to be removed without a hysterectomy.

So the answer to the question – “Should you freeze your eggs before having your fibroids removed?” – is “Yes” and “No”.

The answer may be “no” if the fibroids are small or your doctor is just taking the fibroid out through the vagina (hysteroscopic myomectomy) instead of through a large abdominal incision (abdominal myomectomy).  Many infertile women with fibroids should not have their fibroids removed at all if there are no serious symptoms from the fibroids.

The answer may be “yes” if your doctor feels the fibroids are very large and there is a risk of needing a hysterectomy.

The answer may be “no” if there is no IVF center near you that has egg freezing experience.  Egg freezing is still new and many centers do not yet have any experience freezing eggs, or more importantly, thawing the eggs and yielding a good pregnancy rate.

Egg freezing is so new that, at this time, most insurance companies will not agree to cover the procedure, although ASRM hopes that will change with their recent statement on the new status of this exciting technology.

So the answer is “maybe”.  If you are thinking about having your fibroids removed, talk with your doctor, and talk with a fertility specialist – a reproductive endocrinologist with egg freezing/thawing expertise.  The answer will depend upon your individual circumstances.

Regardless of the answer, the question is an important one.  Be proactive about your health – ask the question.

Copyright Serena H Chen, MD 2012

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