How to remove uterine fibroids (urgent)

Patient's question:

Doctors, hello
I discovered a uterine fibroid in April last year. Ultrasound showed a 4845cm anterior wall and a 6549cm posterior wall. In May, I underwent radiofrequency ablation surgery. In December this year, during a physical examination, the doctor said my uterus was enlarged and retroverted. A transvaginal ultrasound revealed multiple fibroids on the posterior wall. What is going on? The doctor initially said it was completely removed and that I could get pregnant (I haven’t yet). I would like to ask, what can I do to remove the fibroids in this situation? If I don’t remove them, can I still get pregnant normally? Will the baby be healthy?
I am currently 2

Doctor's answer:

Hello.
Uterine fibroids can affect pregnancy, with approximately 25%–40% of patients experiencing infertility. This is related to the size and location of the fibroids. For example, fibroids at the uterine angles can twist and deform the fallopian tubes, affecting the passage of sperm or fertilized eggs and reducing the chances of conception. Submucosal fibroids occupy the uterine cavity, hindering the implantation of fertilized eggs. Larger intramural fibroids can alter the normal shape of the uterine cavity while compressing the fallopian tubes. Therefore, to improve fertility, especially for patients with fibroids and infertility, it is important to seek medical attention promptly. The doctor will adopt different surgical approaches based on the size and location of the fibroids, such as performing an abdominal surgery to remove the fibroids from the uterus or using hysteroscopy to remove submucosal fibroids. This helps preserve the patient's fertility and increases the chances of conception.
So, how long should one wait to get pregnant after fibroid removal? Although the uterus is preserved after fibroid removal, scars remain on the uterine wall, which need time to heal. Otherwise, there is a risk of uterine rupture during pregnancy. Therefore, it is recommended to use contraception for six months after surgery before attempting pregnancy. The pregnancy rate within three years after fibroid removal can reach 60%. For those who want children, it is best to try to conceive within three years. This is because the risk of postoperative fibroid recurrence may increase over time, with a recurrence rate of 10%–20% after three years.
Wishing you a speedy recovery.