Fibroid and Infertility

by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist, KL Fertility Centre (Malaysia)

According to medical history, in the periods of Hippocrates in 460-375 BC , fibroid was known as ‘uterine stone’. The first surgery for fibroid was done for the American President Abraham Lincoln’s cousin in 1809. The term fibroid was introduced in 1860.

Many women had been diagnosed with uterine fibroid. For some the fibroid is not medically important but for some women, fibroid can cause infertility.

What is uterine fibroid?

A woman’s womb or uterus is made up of muscles known as ‘myometrium’ . This ‘myometrium’  is composed of many strands of muscle fibres.

Fibroids arise from genetic alteration in a single muscle fibre. This causes the muscles to overgrow and form a fibroid. Circulating female hormone called oestrogen can cause growth of the fibroid.

However, fibroids can also grow in low oestrogen environment , possibly due to conversion of male hormone called androgens into oestrogen. Yes, females have male hormones too!

The problem with fibroid is , it can be a silent killer. Woman may have fibroids without ever knowing about it!  This is because not all the fibroids cause symptoms. Whether the fibroid causes a problem depends on the size and location of the fibroid.

General problems with Fibroid

a) Heavy Period flow

Generally , fibroids that are located close to the inner layer of the womb (endometrium) , and which distort or displace the womb cavity may cause heavy periods. If untreated , it can lead to anaemia.

b) Pelvic Pain 

Larger fibroids ( more than 4-5cm) may also cause pain and if large enough. Sometimes, the core of the fibroid can become soft leading to severe pain . This is called ‘red degeneration ‘ of fibroid.

A large fibroid can lead to compression of urinary bladder and bowel which leads to difficulty in passing out urine or faeces .

How does fibroids steal your fertility ?

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Fertility Forum :

by Dr Agilan Arjunan, Fertility Specialist, KL Fertility Centre ( Malaysia)


KLF Forum IUI or IVF-Dr Agilan

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Fertility for Cancer Survivors


by Dr Agilan Arjunan



The month of October is dedicated for cancer awareness.

Pink October is a month for breast cancer awareness. There is considerable media attention on the issue of breast cancer and breast cancer survivors .

Thus, it is appropriate and also essential to dwell into a topic so important to all cancer survivors, yet seldom discussed, which is their fertility health preservation. Cancer treatment, specially chemotherapy, can potentially lead to sterility due to its effects on the gonads ( ovaries and testicles).

In recent years, we are seeing more cancer survivors , thanks to the advancement in diagnosis and treatment of all types of cancers. Many childhood and young cancer survivors live through their adulthood and their need to start a family warrants attention.

Typically, the discussion about any fertility preservation technique for a patient starts with their oncologist. The issue becomes more complicated if the patient is a minor. In this situation, parents usually decide in the best interest of their child after discussion with their oncologist and fertility specialist.

The suitability of each methods of fertility preservation depends on the type of cancer, the treatment regime, the time interval between diagnosis and treatment and the status of sexual development of the patient (i.e pre-pubertal vs post-pubertal).

Post-pubertal boys / Young adults

In post-pubertal boys and young adults, the most established method of fertility preservation is cryopreservation of their sperm . This is simply known as sperm freezing. Sperms that are frozen can be kept in liquid nitrogen for many years. Once the patient had overcome his struggles and ready to start a family, his sperm can be thawed and with the assistance of reproductive techniques , he can realise his hope of have his own child.

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