Identifying fibroids
Pelvic ultrasound is the primary diagnostic tool. MRI for surgical planning of large or complex fibroids. We characterise by location (subserosal, intramural, submucosal), size, and number for treatment planning.
From medical to surgical
Medical – hormonal management, ulipristal acetate, GnRH agonists for short-term shrinkage.
Conservative interventional – uterine artery embolisation, focused ultrasound.
Surgical – hysteroscopic resection (submucosal), laparoscopic myomectomy (fertility preservation), hysterectomy (definitive).
When fibroids affect pregnancy
Submucosal fibroids distorting the cavity significantly impair fertility – hysteroscopic resection is highly effective. Other locations may need myomectomy for fertility benefit. We individualise based on symptoms, fertility goals, and fibroid characteristics.
Fibroid treatment options
| Option | When it is used |
|---|---|
| Monitoring | Small, asymptomatic |
| Medical therapy | Bleeding control |
| Myomectomy | Keep the uterus / fertility |
| Hysterectomy | Family complete |
| Uterine artery embolisation | Selected cases |
Frequently asked
Dr Patel provides evidence-based gynaecological care at Balaji Horizon — from medical management to advanced minimal-access surgery — with a precision, organ- and fertility-sparing philosophy and honest counselling on every option.
Evidence-based gynaecology and minimal-access surgery — with a clear, honest plan built around your priorities.
Free Patient Guide
The Fibroids Decision Guide
A clinical primer on uterine fibroids – FIGO classification, when fibroids actually need treatment, the four decisions in care, surgical options including hysteroscopic and laparoscopic myomectomy, fertility preservation, and ten questions for fibroid surgeons.
Reviewed by Dr. Priyadatt Patel — read in 20–25 minutes
Free — delivered to your inbox
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1:02
Fibroids — when to treat, and how to choose
Uterine fibroids are very common and often cause no problems at all. The right question is not simply “do I have fibroids?” but “are these fibroids causing symptoms, and do they need treatment?” Many are best left alone and simply monitored.
When treatment is justified
Treatment is considered for heavy or prolonged bleeding, pressure or pain, or where a fibroid is distorting the cavity and affecting fertility or pregnancy. Size alone is rarely a reason to operate — symptoms and goals are what matter.
The options, matched to you
Choices range from medical management for bleeding (including hormonal options and the Mirena system), through fertility-sparing myomectomy to remove fibroids while keeping the uterus, to uterine artery embolisation, and hysterectomy only when childbearing is complete and other routes are exhausted. Whether you want to preserve fertility strongly shapes the recommendation.
Our approach
We aim for the least intervention that resolves your symptoms and protects your fertility and uterus where you wish — not surgery by default. Accurate ultrasound mapping of number, size and position guides a plan built around your priorities.
When treatment is genuinely indicated, our preference is uterus-sparing surgery — see laparoscopic myomectomy. And when a cyst is found alongside fibroids, read about ovarian cyst surgery.
If surgery is on the table, read our honest guide to fibroid surgery in Ahmedabad — including uterus-sparing options and when surgery is genuinely needed.
Uterus-sparing first — matching treatment to your goals
Most fibroids never need surgery, and when treatment is needed the modern principle is to preserve the uterus wherever possible and match the approach to your symptoms and plans — not to the fibroid alone. A small, symptom-free fibroid found incidentally can usually be watched. When fibroids cause heavy bleeding, medical options — tranexamic acid, hormonal treatment, or a levonorgestrel intrauterine system in suitable cases — are tried before surgery. Where surgery is genuinely indicated, myomectomy (removing the fibroids while keeping the uterus) is preferred for women who want to retain fertility or their uterus; hysterectomy is reserved for those who have completed their family and choose it after other options have been weighed. Uterine-artery embolisation and other uterus-sparing techniques have a role in selected cases.
Fibroids, fertility and pregnancy
Whether a fibroid affects fertility depends mainly on its position, not just its size: those distorting the uterine cavity (submucosal) matter most, while many fibroids within the muscle wall or on the outer surface do not need removing before conceiving. A decision to do a myomectomy before pregnancy weighs any likely benefit against the operation’s own risks, and is made individually. In pregnancy most fibroids stay stable and are simply monitored.
When to seek review
Heavy or prolonged periods, pelvic pressure or bloating, frequent urination, or difficulty conceiving alongside known fibroids all warrant assessment. The aim is always the least intervention that genuinely helps. Related: heavy menstrual bleeding, laparoscopic myomectomy, menstrual disorders.
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
