Rosta, a long-awaited myomectomy 

I wake up in this hospital room. I don’t feel any pain. Is it the effects of the anesthesia or simply the joy of knowing that the uterine fibroids have finally been removed? I don’t know. My uterus has been slit. More than a dozen fibroids have been removed. More than three hours under general anesthesia. Now my recovery begins. I feel free. 

Stage 1: It’s nothing, just benign, non-cancerous tumors. I have no pain and many black women do. 

In 2014, during an ultrasound following pelvic pain, the doctor informed me that I had uterine fibroids. 

Me: “What are they?” 

Him: “These are benign tumors located in the uterus“. 

Me: “Is it dangerous?” 

Him: “No, many black women are carriers of fibroids”. 

Benign tumors. Not cancerous. Many black women have them. I have no pain. OK, it’s nothing! 

Having as precept “It is better to prevent than to cure”, every year, I take an ultrasound test. The 3 subserous fibroids increase. But I am assured that it is still nothing! I have no symptoms. 

At the end of 2016, I meet Aïssatou, from Fibromelles (now the Vivre 100 fibromes association) who campaigns for knowledge of uterine fibroids. She tells me about her experience. We are several women there listening to her. Two or three say they have uterine fibroids.   

Aïssatou’s sentence remains etched in my mind: “We are often asked to feel our breasts for control purposes. Why aren’t we asked to feel our belly to detect the presence or absence of an abnormal abdominal mass?” 

Motivated by the fight of this woman who campaigns for women’s health, I decide to join the Vivre 100 Fibromes association. There, I discover more and more this disease. I have no idea that these muscle cells will lead me to undergo the first operation of my life. But they don’t seem so benign anymore. The numbers speak: 

  • 30% of uterine ablations in Canada are due to uterine fibroids.
  • 30 to 50% of women are carriers of fibroids
  • Up to 80% of black women and 70% of white women

I feel lucky because unlike some women, I have none of the pain: 

  • No painful and abundant periods
  • No pain during intercourse
  • No abdominal swelling.

 

I am what is known in medical jargon as “asymptomatic” (having no clinical symptoms). Nevertheless, some fibroids continue to grow and one of the fibroids is now almost 9 centimeters in diameter, about the size of a 14-week-old embryo. I’m still lucky not to have the belly of a 14-week pregnant woman. 

Following my principle “It is better to prevent than to cure” and knowing that everything that is not expressed leaves its imprint, I seek to understand the cause of my illness. 

My illness – Evil ness – is trying to tell me something. In Ayurveda and in many other medical precepts, the uterus is the symbol of femininity, creativity, fertility, a place of memory… It connects us to our feminine power. So, what has not been expressed? 

Source: http://www.1001fecondites.com/2011/10/matrice-uterine-berceau-de-fecondite-et.html 

 

In order to better understand my menstrual cycle, I download an application to list all the symptoms during my period; very useful when gynecologists ask me questions about my cycle. I also follow a training with Séréna Québec on the symptothermal method which allows you to identify the fertile and infertile periods of the cycle. Having a better knowledge of my body and becoming aware of all the little changes that occur during my cycle is very beneficial. 

 

I consult a naturopath, an osteopath, and an acupuncturist. I modify my diet and favour organic foods as much as possible, consuming more raw vegetables, avoiding industrial milks and tea. Milk thistle, which helps support liver activity, becomes a friend of mine. Following the recommendations of my acupuncturist specialized in fertility (gynecologist in her country of origin), I start drinking warm or room temperature water. This helps stimulate natural digestive enzymes and improve digestion. 

In addition to sports, which I do regularly, I add the practice of yoga. 

I won’t say it has a direct effect on the bigger fibroids, but I’m sure it helps my well-being and that of my uterus and prevents some of the fibroids from growing. 

Phase 2: Pain, Stress and Medical wandering. 

During the summer of 2017, a friend asks me if I was pregnant. No! My belly has swelled. My bladder is under increasing pressure from the fibroids. My sleep is frequently interrupted by this discomfort. I go from asymptomatic to symptomatic. 

From September to November 2017, I perform 2 ultrasounds. I make 2 medical visits to 2 different gynecologists. At each appointment, I bring all my ultrasounds (very important when you don’t have a family doctor). My goal: to find an understanding doctor who agrees to follow me and perform a myomectomy. This surgical procedure under general anesthesia consists of removing uterine fibroids. Unlike hysterectomy, the uterus is preserved. 

The first gynecologist gives me a prescription for an MRI (Magnetic Resonance Imaging), but in the meantime recommends that I take Fibristal, then do the MRI afterwards. This medication may cause fibroids to shrink by blocking the effects of progesterone on the endometrium. You should know that progesterone is a hormone that stimulates the formation and growth of fibroids. Given the listed side effects and the minimal likelihood of it having an effect on my large fibroids, I decide not to take this medication. Eager to have a second opinion, I consult a gynecologist. She does not consider my case alarming because my symptoms are not significant. Nevertheless, she prescribes me a pelvic ultrasound. 

At the beginning of December, I am back with this 2nd gynecologist. After hearing my argument, she finally agrees to put me on the hospital’s waiting list for a myomectomy which will probably take place in the next 6 months. 

On January 11, 2018, I feel intense pain in my lower abdomen. I have a constant urge to urinate, but no burning when urinating. I wake up 6 times during the night. I think I’m dealing with a urinary tract infection. The next day, I rush to the doctor. A urine test is performed. Antibiotics and sick leave are prescribed. 

From Friday to Sunday, the pain is more and more intense. Antibiotics and cranberry juice have no effect. I feel an intense pinching sensation at the level of the fibroid and twinges. All the hypotheses run through my brain. Aïssatou tells me about necrosis of the fibroid (the withering away of a fibroid caused by a drop in the blood supply) or the torsion of a pedunculated subserous fibroid. 

On Monday, I am back at the medical clinic. Another doctor consults me. The results of the urine tests are negative. I inform him of the hypothesis of necrosis of one of the fibroids. Confronted, he asks me if I am in the medical field. Not at all! I’m just trying to figure out what’s going on in my body. After an abdominal palpation which provokes a high-pitched scream, the doctor assumes that it is an inflammation of the peritoneum or indeed necrosis. An X-ray or MRI is needed to make a diagnosis. He sends me to the emergency room of the hospital where I am on the waiting list for the operation. 

Approached by a student doctor, I again explain my pain, the history of fibroids, the waiting list… I tell him that I am under the care of a gynecologist at this same hospital. 

She tries to palpate the cervix, without success. Another student doctor joins her. I tell him the same story again. He wants to examine the cervix again. “Your colleague just did it. She wasn’t able to do it.” I tell him with exasperation. He insists. He does it. Identical result. 

I ask them to contact the gynecologist who follows me in this hospital. Surprisingly, I never see him. 

I ask that he check that it is not an inflammation of the peritoneum. Impossible according to them; I have no fever or vomiting. I demand an ultrasound. After 30 minutes of waiting, the 2 student doctors, accompanied by the head gynecologist and a machine to perform an X-ray, join me. After 5 minutes, the head doctor says to me: “You have large fibroids! The results of the urine test and the blood test are normal except for a slight anemia. You can go home. There seems to be nothing abnormal “. 

For those who know Nicky Larson, my desire at that time is perfectly illustrated by this image. It’s a good thing I didn’t have a sledgehammer… 

 

I insist on another ultrasound. It is out of the question that I go home without knowing the cause of my suffering. I get an appointment for the next day at the radiology department. He gives me a prescription for analgesics and anti-inflammatories to take depending on the intensity of the pain, for an indefinite period. 

Before leaving, the doctor warns me: “It’s not sure whether we will see something with an ultrasound”. I reply: “Okay! In that case, what do we do?” I have no answers. I am beside myself. 

By insisting for answers, I sometimes feel that my case annoys the doctors in front of me. I’m sure they’re not denying my pain, but in some way, I’m underlining their failure. They offer me no solutions, no answers. 

Dozens of questions race through my brain. Will these anti-inflammatories affect my intestinal flora? What can I take to protect it? How long should I take them? How do I justify my repeated absences to my employer? Will I ever find a doctor who will listen to me and agree to operate on me? How long will it take? 

To my great despair, in order to alleviate my suffering, I decide to take Fibristal for a month. 

Phase 3: the week of miracles called compassion, empathy, and liberation. 

I go to a private radiology clinic to perform the MRI that was prescribed to me a few months earlier. The attention and sympathy of the medical assistant touch me deeply. Even though I am surrounded by wonderful family and friends, I finally have the feeling of being helped by someone close to the medical profession. The MRI completed, I leave with the CD. I have to wait 10 days for the doctor to receive the results. 

Ten days later, still on anti-inflammatories, I’m back in the gynecologist’s office. The long-awaited and well-known result falls: the largest fibroid is necrotic. At first glance, this is good news since it means that the fibroid is dying. But how long will the pain last? What can I do to reduce the intensity? 

“What do we do?” I ask the doctor. I receive the answer like a stab to the body: “There is nothing we can do except take the anti-inflammatories.” he says. 

The excess of tears held back for days now flow down my face. I look at the doctor and say to him: “I am not talking to the doctor, but to another human being. In front of you, you have a human being who has been suffering for 3 weeks now, who is on anti-inflammatories for an indefinite period. You are in the medical field. You know doctors who can operate on me. I can wait until April if necessary, but help me find a doctor who will operate on me. “ 

Three hours later, I am in front of the doctor who will operate on me in the following days. My pain has finally been heard. 

On February 7 at 6:30 am, I am in the hospital to undergo the long-awaited myomectomy. 

At 6:45 a.m., I’m in the taxi on my way home. The nurse informed me 5 minutes after my arrival that the obstetrician-gynecologist canceled all her interventions. 

I go from relief to despair. I can’t think anymore, I’m so tired. I don’t want to fight anymore. At that time, my friend Fauve who accompanies me shows me an email she received that morning. A real balm to the heart! At 8 a.m., I call the doctor’s office to ask for another date for the operation. I learn that the doctor is waiting for his patients in the operating room. He hadn’t canceled his operations. Big administrative error! Impossible to operate on me since I had just had my breakfast. The Quebec health system is suffering, my dear friends! My suffering will have an end. But when will our health system be cured? In short, that’s a whole different story! 

The myomectomy by laparotomy under general anesthesia took place on February 21. More than 3 hours in the operating room. A superb medical team took care of me. More than ten subserous fibroids removed. Four nights in the hospital. A beautiful scar described as a work of art by the nurses. I assure you; my scar no longer looks like that! 

During my two months of convalescence I concentrated on rest, yoga, massage of the scar with essential oils, vegetable soups and aloe Vera juice. 

I know fibroids can come back. But today, I am up and fighting. I would like to thank all the people who surrounded me with their love as well as the Vivre 100 Fibromes association. 

    

Source: my niece 

Make this phrase a rule of life: “If you are in severe pain or discomfort, don’t let the medical staff force you to be quiet. Stay firm because you might just save your own life. 

Never give up when it comes to your health. Listen to your body. Seek to know, to understand your illness. Inform yourself. Assemble your medical file. Knock on multiple doors. Ask for different opinions. Surround yourself with people who support you. And above all, keep hoping that a door will open. 

Mounia, 30 years old – My pregnancy, my miracle

Hello, my name is Mounia. I am French of Beninese origin. I am 30 years old, and I have a fibroid uterus.

It all started a year and a half ago when I suddenly started having dizziness, menorrhagia (abnormally abundant and longer periods) and dysmenorrhea (pain during menstruation) more severe than during puberty. So I consulted a gynecologist and the diagnosis of uterine fibroid was made. The gynecologist prescribed me iron tablets to prevent anemia and I continued to ease my menstrual pain with a hot water bottle, because I am an “anti-med”.

A moment of respite: short-lived

Over the months, I almost forgot about my fibroids. Another pain came to disturb my daily life: a lumbar sprain. This caused unbearable sharp pains which prevented me from walking properly and from sleeping, and which, morally, wore me out. So I had to consult a GP in private who referred me to a gynecologist. This one, after several examinations, pointed out my fibroids and explained that it would be difficult for me to procreate (although not impossible) and that it was important to follow up on me to check their evolution.

My miracle

A month later, during an indoor training session, I suffer from violent vertigo that makes me lose my balance. Worried (my period being close), I wonder if I have anemia. As a result, I wait a few days to observe what will happen, but it doesn’t come…

Ten days after the expected date of my menstrual cycle, I decide to take a pregnancy test: it is positive.

I am regnant.

My pregnancy

I get back in touch with the gynecologist in private practice. Surprised, she explains to me that this is good news but that there is no guarantee that I will spend the first 12 weeks without losing the baby.

I am then referred to a gynecologist close to my home who, 12 weeks later, explains to me that the pregnancy is at risk because my fibroids have grown. I have six, one of which is the size of my uterus: there’s an 80% chance that I will give birth by caesarean section. It is disconcerting to receive all this information at the same time while carrying the miracle of life within us. But I cling to my faith and above all, I completely get out of my routine: I stop all my sports activities, I

don’t go out anymore, I watch what I eat so as not to gain excess weight. And the days are reduced to going to work and coming home to sleep. I sleep a lot, I eat healthy, and I drink a huge amount of water.

During my fifth month, I see my gynecologist again to plan a trip to Paris. After an improvised ultrasound, he tells me that my baby is in the breech position but is doing very well, and that my large fibroid has grown but does not affect my pregnancy in any way. I am recommended compression stockings, nothing more. I have the right to fly. My stay goes well. Back ten days later, I plan a new meeting with my gynecologist where we determine our next meetings and the date of the cesarean section: June 18, 2019.

The eighth month begins. My mother has arrived, I start my last days at work, and I feel that my “petit loup” is descending, my belly is big, heavy, it’s hard to sleep, but I maintain my good mood. New twist: trying to turn Kiyam so that his head faces down… Failure. The dominant fibroid is preventing my son’s head from going through.

June 15, 2019: I wake up at the end of a normal night of end of pregnancy, a planned day spent with mom, my spouse arrives from Paris in the evening, the day begins. Around 1 p.m., I feel an intense pain which shakes my body violently, but which, according to my mother, does not mean I am ready to give birth. An hour later, another back pain in the shower and mom tells me to hurry so my water doesn’t break if the process starts. Finally, during our errands, my contractions begin and accelerate. At 5:30 p.m. I find myself at the maternity ward of St-Mary’s Hospital Center; I’m 4 centimeters dilated. The team prepares me for the operating room, my partner has just landed and arrives around 6 p.m., I am 6 centimeters away, we enter the operating room…

Kiyam is born at 7:45 p.m. this June 15, 2019.

I am grateful and blessed.

There is the strength of medicine, personal strength, but above all, Divine strength.

 

Mounia

Cathia, I am a survivor who chose hysterectomy

Hello, my name is Cathia and I am a survivor.

I’d had very abundant menstruations for a week. I knew it was due to the fibroids I had had for years. At dawn on June 14, 2017, during my week’s vacation, I was losing a lot – far too much – blood (large clots). My instinct told me that was not normal. I had also become very pale, I had a lot of stretch marks on my legs, I was losing a lot of hair every time I combed my hair. My vision was very blurred, and I felt more tired than usual.

On June 14, 2017, in the middle of the night, I sat on the edge of my bed. I didn’t know for what reason. I simply felt a force pushing me to stand up suddenly. That’s when I got dressed and drove to St. Mary’s Hospital.

I had a friend who worked nights at this hospital, so I contacted her to let her know about my situation. As soon as I arrived at the emergency room, the nurse on duty took my blood pressure. While I was lying in one of the consultation rooms, seven different doctors came to see me to ask me about my state of health. I began to imagine all the bad news that these doctors were going to tell me.

My friend went to see the nurse to find out more about my condition. Instead of answering, she started asking her questions about me, asking if I got up every morning, went to work, and led a normal life like everyone else. My friend said yes, so the nurse explained to her that my hemoglobin level was extremely low and added that if I had waited even one more day, I might have died.

After their diagnosis, the doctors decided that it was urgent that I undergo an operation to remove the fibroids, but given the significant drop in my blood cells, they concluded that it would be too risky to operate on me in my current state. They decided to give me a blood transfusion and put me under observation to regulate my blood cell count.

After spending the night and the next day in the emergency room, I was discharged from the hospital and given about twenty types of medication to take a day to stabilize my blood loss while waiting for surgery. Despite the urgency of my condition, I was put on a waiting list for surgery.

During this time, the ultrasounds that had been carried out detected 6 fibroids measuring 10 cm each as well as a cyst on my left side, at the bottom of my belly.

After a few weeks of waiting, the hospital contacted me to inform me that the surgery would take place on July 25 at 12:30 p.m. I decided to have a hysterectomy (the removal of the uterus) despite the advice of my gynecologist who insisted that I was still young and could have children. I think that at the time I let fear take over and refused to hear anything anyone had to say. I said no and demanded that he remove the uterus. My doctor explained to me that the operation would last a maximum of two hours and that the next day I would be discharged from the hospital followed by a period of convalescence. On the day of my operation, I greeted my loved ones and added: “See you in two hours!”

When I opened my eyes in the recovery room, I looked at the clock in astonishment. It was 8 p.m.! The nurse said hello and I was shown to my room. Seeing me, my relatives shared an expression of relief after hours of worry without news.

Once installed in my room, I had urinary discharges. The stitches in my bladder were torn because they weren’t tight enough. Instead of urinating into the catheter, I had urine leaking out of the seam. A doctor on duty came to sew me up like a seamstress coming to do alterations on a suit. Phew!

Following my operation, three days go by without any news from my gynecologist for my follow-up. Finally, after a week to the day, my surgeon showed up to explain to me how my operation had gone. He began by saying to me: “Madam, I have never had to undergo an operation as complicated as yours!” He pursued. “During the operation, there were so many fibroids in your belly that they had made a hole in your bladder,” he says. Also, he couldn’t find my uterus. I never knew a uterus could move. I always thought it was all connected. The surgeon told me that he had finally been able to locate my uterus under my right breast and that after the operation, I could not wake up. OMG! I did not understand what this doctor was telling me. For me, it seemed like he was explaining the script for a horror movie released at the cinema. I couldn’t find any logic in his words. To conclude, the surgeon told me that everything was back to normal, that everything would be better for me and that I was like new. I thanked him. He wished me a speedy recovery and informed me of my release from the hospital.

This is my experience with fibroids! I consider myself a survivor. Now, by the grace of God, I’m fine

I hope my testimony can inform women of the importance of listening to their body, of paying attention to any unusual changes that appear suddenly or gradually in their body. If in doubt, ladies, go see a doctor, because it’s always better to be safe than sorry.

I want to thank the organization Vivre 100 fibromes, which informs, raises awareness, and gives resources to women who live with this scourge that affects so many women in the world. Good continuity !

Cathia, the survivor

My fibroma, ”the invader”, 9 cm, 200g – the fibromella is doing better.

The hell of painful periods

“You’re normal, unfortunately that’s what being a woman is,” the first gynecologist I saw told me, scribbling a prescription on a piece of paper for stronger anti-inflammatories for my menstrual pain.

How do you want a woman to feel confident, listened to, reassured, when some gynecologists do not even take the time to listen to her, to examine her in order to discover the origin of her ailments?

I have always had menstrual pain to the point where I sometimes missed school and work, finding myself walking back and forth, hunched over between the bed and the bathroom to vomit. Only the hot or even burning shower could relieve me in part. Medication? They all made me nauseous and ended up at the bottom of the toilet bowl barely ingested.

 

Month after month, year after year, I had ended up getting used to it while apprehending the arrival of these “damn English”. If that was what being a woman was, then I had to be strong mentally and physically because the hardest thing to come was giving birth, right?

The onset of symptoms

During my 31st year, in 2019, I noticed changes in my menstruations; they were more abundant. I was changing sanitary napkins every hour which forced me to switch from regular pads to night ones. The blood clots were literally pushing the tampons out. As I had seen the gynecologist a few months before and he had told me that I was “normal”, I attributed these changes to the account of “old age”, surely part of the transition to my thirties.

Every month, I lived with these new periods, I adapted my outings, I changed regularly; I woke up several times a night only to notice the accidents on the sheets. It had become my new monthly routine.

A year later, August 2020, I started having a feeling of heaviness and pelvic burning, I had frequent urges to urinate at night, a small abdominal bump appeared when I lay on my back, and lower back pain, which had appeared a few months earlier, was becoming more and more bothersome. The stress at work linked to the Covid, and the fatigue due to the preparations for my move from Montreal to Saguenay, meant that I preferred to wait until I was settled in my new region before consulting.

 

The diagnosis

We are in early October 2020. I was able to get an appointment at a clinic fairly quickly; after a few questions, the doctor thinks it is a gynecological problem.

“But are you sure you’re not pregnant? Your uterus is very big, could this be an ectopic pregnancy?” she says to me in amazement.

I didn’t know what to say to her, I was so shocked. She then prescribed me complete blood tests as well as a urinalysis. The pregnancy test was negative, but I had an iron deficiency anemia caused by my heavy monthly blood loss. So that was why I complained all the time about being tired, that I was out of breath after the hikes. There followed three months of iron supplements and monthly blood tests while waiting for a gynecological appointment.

At the end of October, I have an appointment at the hospital for a TACO (a kind of abdominal scan): “9 cm mass suggestive of an intramural or submucous myoma which deforms the cavity endometriosis versus a straight ovarian lesion. A pelvic ultrasound in gynecology is recommended as soon as possible.”

It was during this time that the Vivre 100 Fibromes (Live without Fibroids) association was of great help to me, my spare wheel in this maze of information. Even before having my pelvic and vaginal ultrasound and my appointment with the gynecologist, I was able to understand my symptoms, the ailments that had lasted for all these years, and managed to put the puzzle together: menstrual pain, bleeding , pelvic pain, pain during intercourse, fatigue, lower back pain, bloating, the little bump… everything was linked to this fibroid, the ”invader” as I had nicknamed it. Thanks to the association, I had all the keys in hand to make an informed decision about the management of my fibroid.

Surgery or HIFU?

At the beginning of December 2020, the gynecological appointment and the ultrasound finally arrive. My legs, jaw and voice were shaking so much I felt helpless and stressed. But for the first time, I felt listened to and understood. The gynecologist decided to put me on the priority list of her surgeries and explained to me that the intervention was called a myomectomy by laparotomy, that she was going to make a small incision like a cesarian section and remove this ” snowball ” which would in any case prevent any fetus from developing as the fibroid was presently deforming the uterus. Seeing as she had never heard of HIFU, she left me free to do my research while keeping me on her priority list.

Following the precious advice of a fibromella, I immediately put together my file for the HIFU and sent everything to Bordeaux at the end of December. Around mid-January, I receive the answer: in my case, only surgery is possible. I was both disappointed with the response, relieved to have had a second opinion, but also proud to have followed through with my efforts without any regrets.

D-day

On March 4, 2021, I received the call for my surgery.

On March 8, Covid screening and pre-operative examinations.

March 9 is D-Day. After a final blood test, and once changed into my surgery gown, I head to the operating room with the nurse where the surgeon, the resident gynecologist, the anesthesiologist, and the respiratory therapist are waiting for me. Everyone introduces themselves and is kind to me. The nurse asks me to explain in my own words the intervention that I will undergo: “a caesarean section but instead of taking out a baby it is a mass that they will remove from me”. The gynecologist then approaches me and asks me if I am ready. I answer: “Do I really have a choice?” She reassures me by telling me that she will do everything in her power to make sure everything goes well. Those are the last words I remember before I fell asleep. The surgery lasted approximately one hour and thirty minutes.

I wake up quietly with some nausea. The nurse injects me with an anti-nausea and 1 hour later I am stable enough to transfer to a room.

I stayed in the hospital for 3 days with a urinary catheter, intravenous fluids, and a small morphine pump to control the pain. To tell you the truth, after all these years of suffering, I was somehow mentally and physically conditioned: the post-operative pain seemed more bearable to me.

“2 months of work stoppage, 1 month without sexual intercourse, 6 months without trying to get pregnant, and scheduled delivery by compulsory caesarean if I become pregnant”.

These are the doctor’s recommendations upon discharge from the hospital.

The return home was difficult, but my boyfriend was there for all the small, innocuous daily actions: walking, getting up, sitting down, going to the bathroom, getting dressed, putting on my shoes. But day by day, we saw a marked improvement and I gradually regained my autonomy.

 

Conclusion

Although surgery can be risky, the hardest thing for me has been the wait: waiting for a diagnosis, living in uncertainty, not knowing what I had for weeks or months. We invent scenarios, we play Dr Google while doing research on the internet. We create our own fear and anxiety. I think I was still fortunate enough to come across the right people, at the right time, to take charge of caring for me, but there is still one thing that bothers me and makes me react:

If we know that fibroids are hereditary, that women past 30 who have not had children are more likely to have them, then why not do preventive examinations in the same way as mammograms? Why wait for symptoms to appear or worsen to hear about it from doctors, but also from those around you, as if it were a subject that is taboo?

Sandrine, 38 years old; I have a fibroid uterus and I had a child through in vitro fertilization

Hello, my name is Sandrine, I am African, I am 38 years old, and I have a fibroid uterus.

It all started 8 years ago when I discovered that I had a small more or less rounded lump in my lower abdomen which, although painless, worried me a lot. Yes, feeling that you have a mass in your abdomen can be very worrisome. Being a thin person, this mass was more accentuated when lying down than standing up. I actually felt it for the first time in a lying position. Before that I had noticed that I had menorrhagia during my periods; my periods had become abnormally abundant and long. Regarding dysmenorrhea, unlike my sisters, I had had it since puberty. I thus consulted a gynecologist, and the diagnosis of uterine fibroid was made. The gynecologist put me on progestin combined with iron because I had anemia. I was taking my anti-inflammatories as usual during my periods.

Over the months and years, the fibroids grew bigger. They became very bothersome, and in addition to the frequent bleeding I began to have excruciating pain which led me to the emergency room each time because I needed upper-level and intravenous analgesics to calm me down. I still remember my screams and my tears at that time: it was excruciating. In addition to living this every month, I was also very fragile mentally and psychically.

I underwent a laparotomy myomectomy in 2012, two years after the diagnosis.

This was made necessary because of the debilitating pain, the heavy bleeding, the severe anemia I had (the doctors had even considered a blood transfusion during the operation), and to facilitate a subsequent pregnancy. Three months after I recovered from the intervention, my doctor advised me to conceive a child as soon as possible because nature abhors a vacuum. It is important to know that depending on the location of the fibroid, the symptoms, its size, it is sometimes difficult to escape surgery. Hysterectomy is possible, but the uterus is kept if a pregnancy is desired, especially when you are still of childbearing age. A few months after my operation, my cycle became regular. I still had fibroids, but they were asymptomatic. During the operation, we only removed the largest, which measured about 16 centimeters.

I finally met the man of my life several years later, in 2014. We decided to form a couple in 2015. Both of us wanted children. I made it clear to my partner that I had undergone a myomectomy.

In 2016, as I was unable to conceive, we went to the procrea clinic (clinic for assisted procreation) to consult and discuss other alternatives.

We carried out several tests within this clinic to find out what was the origin of the problem. The tests, of course, showed that it came from me. The fertility check-up found several fibroids (I had 15 now and they had increased in size), a low ovarian reserve and the hysterosalpingogram showed that I had both tubes blocked. My gynecologist explained to me that given my “advanced” age, it was better for us to go directly for IVF (In Vitro Fertilization). But to guarantee its success, it was necessary to reduce the size of the fibroid. She also advised me to freeze my eggs. I was therefore put on Fibristal for 3 months to reduce the size of the fibroids. Artificial insemination had not been considered, because for that it was necessary to have permeable tubes, which was not my case.

However, I did not like the clinic, and we decided to transfer our file to the McGill reproduction center. I had in my entourage 2 friends who had been cared for there. For my part it was very important that I connect with the doctor who would follow us, to feel understood, supported and to receive answers to my questions. In terms of the cost of IVF, it was also relatively less expensive at the McGill reproduction center. I therefore went there with my partner where we redid the tests. I had been taking fibristal for 3 months already and, good news, the ultrasound showed the consequent reduction of my fibroids. It was agreed that I would take fibristal for another 3 months. After that, the hysterosalpingogram showed that I had permeable tubes. It was actually fibroids blocking my tubes.

As my fallopian tubes were permeable, I resorted to artificial insemination (AI).

We thus started the AI process, which is covered by the government for 9 trials. On the first day of my period, we meet a nurse who explains everything to us. We obtain the proper medicines which are available in specific pharmacies. We come back to see the nurse with the drugs; she explains how to administer the injections and for how long. An appointment is then made for blood tests and the follow-up ultrasound. The day finally comes when the treatment is modified and you are asked to inject yourself with the molecule that will trigger ovulation and to come the next day to do the insemination with your partner’s sperm.

I was very positive during this process because for me there was no reason for it not to work because neither I nor my spouse had other problems. I was always thinking about my treatment and doing my best to never be late for my injections. But we tried twice and failed both times, which affected me a lot psychologically. On the second attempt I cried a lot when I had my period. But luckily, I was not alone; my husband was fully by my side during these trials and he supported me a lot.

After these two attempts I needed to take a 2-month break.

After this period, we went back to see the gynecologist with the decision to do IVF.

The IVF hormone treatment was more laborious. Some AI molecules were renewed but there were several others and I had to prepare myself psychologically to resume these injections. On the first day of your period, we must call a number given in advance to make an appointment for an “IVF” ultrasound for day 2 or day 3 of your cycle. On Day 2, after the ultrasound, we are advised by a nurse to start our hormone injections (Puregon + Repronex). On the 6th day of injection, we start a new injection (cetrotide) which must be taken in the morning, while continuing with the other injections. The next ultrasound is done on the 8th day of the injections and a blood test is taken on the same day. Further ultrasounds are planned depending on how our body responds to the treatment. The idea being to maximize follicular stimulation.

My egg retrieval took place about 2 weeks into the process. I had been able to produce 5 follicles. My husband was also present to donate his sperm for IVF. A day before, on the recommendation of the nurse, I had injected the hormone HCG. After the egg retrieval, I received 3 more prescriptions to prepare for the embryo transfer. This took place 3 days after the egg retrieval. The culture only gave 2 embryos which were all transferred to my uterus.

After the transfer we made an appointment for the pregnancy test. The medical team at the Reproduction Center gave us recommendations concerning the lifestyle to adopt (diet, vitamins, exercise, hygiene, sexual relations, stress, etc.). In the meantime, I had to continue with the intravaginal endometrin. I did my best not to be stressed during this waiting period. It was hard. On the day of the appointment for the pregnancy test, about ten days later, I went to the reproduction center and they took a blood sample. The nurse reassured me that I would receive a call that same day to tell me if I was pregnant or not. On the way home I bought a rapid pregnancy test; I was so impatient; I didn’t want to wait. But I was unable to perform the test and waited. In the afternoon the center called me with positive news. My IVF worked on our first try. It was total bliss. The miracle had happened. I was going to have twins. I don’t remember exactly when, but 1 to 2 months later I had my first pregnancy ultrasound and the gynecologist told me at that time that only one embryo had survived. This news saddened me a lot because I wanted a twin pregnancy, “to have two babies for the price of one”.

My first and second trimester were pretty tough. The fibroids grew with the pregnancy and were sometimes so painful that I had to be hospitalized several times. I was always afraid of losing my baby. My third trimester was the easiest. IVF can be hard to bear both morally and financially, but it’s worth the cost! I was ready to make any sacrifice to be a mother. I think that at a certain age you shouldn’t wait too long and think about it but go for it with the possibilities of assisted medical procreation that are available to us. It is also important to believe that it can work and to persevere despite some negative results.

 

Sandrine