Uterine Fibroids Treatment in Ahmedabad

Your ultrasound report says “fibroids.” Your mind immediately goes to surgery. But here is what most women are never told:

The vast majority of uterine fibroids do not require surgery.

The Most Important Sentence on This Page

A 1cm submucosal fibroid sitting inside the uterine cavity causes significantly more damage to fertility and implantation than a 6cm subserosal fibroid sitting quietly on the outside of the uterus.

Location determines clinical significance. Size alone is not a reason for surgery.

Uterine fibroids — also called myomas or leiomyomas — are benign (non-cancerous) tumours made of smooth muscle tissue that grow in or around the uterus. They are not cancer. They cannot become cancer. And in the majority of women, they never cause any significant problem.

Their growth is driven primarily by oestrogen and progesterone — which is why they tend to develop during the reproductive years and typically shrink or stabilise after menopause. They vary enormously in size — from a few millimetres to, in rare cases, several centimetres.

The reason fibroids matter in the context of fertility is anatomical, not oncological. When a fibroid grows in a location that physically distorts the uterine cavity — the space where an embryo must implant — it interferes mechanically with implantation. When it does not touch the cavity, the uterus functions normally and fertility is unaffected.

Understanding which type of fibroid you have is the single most important step in deciding whether treatment is needed. Here is the complete classification:

FIGO Classification Note

The FIGO (International Federation of Gynaecology and Obstetrics) classification system grades fibroids 0–8 based on position relative to the uterine cavity. Type 0 = fully inside the cavity. Type 8 = far outside the uterus (e.g., cervical). Dr. Shah uses this classification to guide surgical decisions. When relevant, he requests an MRI pelvis for accurate grading prior to planning surgery.

One of the most common mistakes in fibroid management is treating size as the primary decision-making variable. It is not. Here is how the two factors compare in clinical importance:

How Dr. Shah Evaluates Your Fibroid

1. Transvaginal Ultrasound (TVS): First assessment of number, size, and position of fibroids. Identifies any submucosal component.
2. Saline Infusion Sonography (SIS) / Sonohysterography: Saline injected into the uterine cavity under ultrasound. Precisely maps the relationship of the fibroid to the uterine cavity — more accurate than standard ultrasound for submucosal assessment.
3. MRI Pelvis: Requested for large fibroids, multiple fibroids, or cases where surgery is being planned. Provides exact FIGO grade, depth of myometrial penetration, and proximity to important structures.
4. Hysteroscopy: Direct visual inspection of the uterine cavity. Definitive for identifying submucosal fibroids. Allows

The evidence-based answer, summarised: submucosal fibroids reduce IVF success rates by approximately 30–50% and must be removed before embryo transfer. For other types, the evidence is more nuanced:

Submucosal Fibroids — Remove Before IVF or Pregnancy Attempt

• The evidence: Subserosal fibroids — those growing outward from the uterine surface — do not alter the uterine cavity and are generally not associated with reduced fertility or IVF failure rates.
• When Dr. Shah recommends surgery: Subserosal fibroids causing significant pelvic pressure, bladder compression, or pain that impairs quality of life. Not for fertility reasons unless very large (>8–10cm) and causing anatomical distortion.
• Pedunculated subserosal fibroids: Stalked fibroids hanging off the outer uterus. Rarely affect fertility. May occasionally tort (twist on their stalk), causing acute pain. Surgical removal only if symptomatic.
• The right advice: A woman with multiple subserosal fibroids and a clean uterine cavity can proceed to IVF without any fibroid surgery. Doing unnecessary surgery before IVF wastes time and creates recovery delays.

Many fibroids are entirely asymptomatic — discovered incidentally on a routine scan. When symptoms do occur, they typically include:

When fibroid surgery is clinically indicated, Dr. Pranay Shah performs laparoscopic (keyhole) myomectomy — a minimally invasive procedure that removes the fibroid while preserving the uterus completely. This is the most important distinction: myomectomy removes the fibroid. The uterus remains intact.

• What it is: A hysteroscope (thin camera) is passed through the cervix — no incisions, no external cuts. The submucosal fibroid is visualised inside the uterine cavity and resected (shaved down) using an electrosurgical loop.
• Best for: FIGO Type 0 (fully inside cavity) and Type 1 (majority inside cavity). Some Type 2 fibroids can also be treated hysteroscopically in experienced hands.
• Anaesthesia: General anaesthesia or sedation. Day procedure — home same day.
• Recovery: 1–2 weeks before fertility treatment can resume. The fastest return-to-IVF timeline of any fibroid surgery.
• Read more: Hysteroscopy at Wellspring IVF — full procedure guide on our Hysteroscopy page.

Fibroids and Adenomyosis are frequently confused — both affect the uterus, both cause heavy periods, and both impact fertility. However, they are fundamentally different conditions requiring different treatment approaches:

If you have a bulky, globular uterus with heavy painful periods and you have been told you have fibroids — ask whether adenomyosis has been specifically excluded. The two conditions frequently coexist, and missing adenomyosis changes the treatment plan significantly. Read our full guide: Adenomyosis Treatment at Wellspring IVF.