Uterine fibroids are the most common benign tumors in gynecology, mostly found in women aged 30-50 years old, and according to statistics, about 20% of women over 30 years old suffer from fibroids. Because many patients do not feel any discomfort, some women are always found to have fibroids during the annual gynecological checkup. With the increase of late marriage and childbirth, some women with fertility requirements are facing a lot of problems with fibroids and fertility, such as: will fibroids affect fertility? What is the risk to the mother and child when a person with fibroids gets pregnant? Is it better to have a baby first or to remove the fibroids first? Will it cause infertility if the fibroids are removed first? Is natural childbirth an option after myoma removal? Is laparoscopic surgery or open surgery better for myoma removal? Will myoma recur after surgery? And so on. I. Can fibroids affect fertility? The effect of fibroids on pregnancy and childbirth is related to the size and location of the fibroids. Smaller fibroids, interstitial fibroids less than 5 cm in diameter, or subplasma fibroids growing towards the surface of the uterus, usually do not affect pregnancy and childbirth. However, larger fibroids or some fibroids with specific growth sites can affect conception. For example, fibroids growing in the horn of the uterus may compress the opening of the fallopian tube and cause obstruction, and fibroids growing in the cervix may compress the cervical canal and prevent sperm from entering, which may cause infertility. What are the risks to the mother and child if a person with fibroids becomes pregnant? The growth of submucosal fibroids into the uterine cavity may affect the fertilized egg and cause miscarriage, and the mechanical compression of interstitial fibroids may deform the uterine cavity or cause miscarriage due to insufficient blood supply to the endometrium. Most pregnancies with fibroids can be delivered spontaneously, but postpartum hemorrhage should be prevented because the fibroids can affect the contraction of the uterus after delivery. In some cases, due to the obstruction of the fibroids, the fetal position may not be correct or the birth canal may be obstructed during delivery, resulting in obstructed labor, which requires a cesarean section. After pregnancy, the hormone level in the body changes, and the existing fibroids usually increase in size faster than before. During pregnancy and puerperium, the fibroids are prone to red degeneration, when they grow rapidly, with severe abdominal pain, fever and elevated white blood cell count, which are usually relieved by conservative treatment. Third, is it better to have children first or to remove fibroids first? This question is based on the patient’s age, the presence or absence of symptoms, the location, size and number of fibroids. If the fibroids are small and asymptomatic, even if there are multiple fibroids, they do not affect pregnancy and delivery. However, the following cases should be considered for myomectomy: 1. large fibroids with a diameter of more than 5 cm and a large number of fibroids, the uterus is already more than two and a half months pregnant when not pregnant; 2. those with symptoms of excessive menstruation and anemia; 3. those with symptoms of bladder and rectal pressure such as frequent urination or poor defecation, or those with fast-growing fibroids and possible degeneration; 4. those with infertility or repeated miscarriages, and other causes have been ruled out. When other causes are considered to be due to fibroids. In addition, age is a very important factor that must be considered. The scar on the uterus after myoma removal needs some time to recover, so it is generally recommended to use contraception for one year after surgery before pregnancy. 4. Will myomectomy cause infertility? There are many reasons for infertility, including male and female factors. Female factors include uterus, ovaries, fallopian tubes, endocrine status, age and many other aspects. In general, myomectomy itself will not cause infertility unless there are other causes of infertility before the surgery or pelvic inflammatory disease or tubal adhesions after the surgery. According to statistics, the pregnancy rate after myomectomy is about 55-75%. 5. Can I choose natural childbirth after myomectomy? It depends on the specific situation, including whether the endometrium was penetrated during myomectomy, the recovery after surgery, how long the pregnancy was after myomectomy, the age of the pregnant woman, whether she has a history of infertility or miscarriage for many years, and so on. If you are pregnant after myomectomy, you should have a pregnancy checkup on time. The doctor will analyze the previous surgery and the current pregnancy and advise you whether to choose natural delivery or cesarean section. Is laparoscopic surgery or open surgery better for myomectomy? Both types of surgery are possible, each with its own advantages and disadvantages. Laparoscopic surgery is less invasive, with three small holes in the abdominal wall and instruments inserted into the abdominal cavity to remove the fibroids. Open surgery is easier to perform under direct vision, but it is more invasive and leaves larger scars on the abdominal wall after surgery. The choice of which surgical procedure is better should also be considered based on the size, location, number of fibroids and the patient’s own wishes. 7. Will myoma recur after myomectomy? The recurrence rate after myomectomy is about 25-35%, and the recurrence rate of multiple myomas is higher than that of single myoma. Nowadays, many professional women are busy with their careers and choose to use contraception for several years after marriage before considering childbirth. It is advisable for these women to have a gynecological examination to rule out fibroids or other genital pathologies before making this choice.