Fibroids complicate 50-70% females of reproductive age group c/c being pain and heavy menstrual bleed. Roughly 5-10% infertile females have fibroids. Fibroids protruding into the cavity of uterus or in the body of uterus and distorting the uterine cavity by pushing the cavity causes infertility. Large intramural fibroid more than 3-4 cm in diameter and located less than 1 cm from the uterine lining usually cause infertility and need to be removed. Sub serous fibroid which are more than 5cm / symptomatic should be removed. Diagnosis is made with 2D 3D USG TVS/ TAS .
MRI with contrast helps differentiating sarcoma, adenomyosis from fibroid. Small fibroids usually don’t need to be treated, if at all oral medicine ulipristal, s.c. goserelin or leuprolide can be used. Fibroids can be removed laparoscopically or laparotomy. In our centre laproscopy is the prefered method. Submucous fibroids are removed by hysteroscopy or methods are UAE or robotic surgery followed by IVF/ICSI .