Question: Hello Doctor, I would like your expert advice regarding the chances of successful IVF using my own eggs. I am 42, my husband is 43. Both of my fallopian tubes are blocked and my husband’s sperm is normal. I've had 4 failed IVF attempts (the first 3 attempts used fresh eggs and the last used frozen eggs). In all cases, all goes well up till the implantation stage where 3 embryos of good quality have been transferred have and failed to implant each time. I also have fribroids (up to 5cm in sixe) and know that Intramural and submucosal fibroids (the scan showed I have both of these types) can adversely affect IVF and pregnancy. My questions are: Should I have some form of surgery to remove the fibroids before attempting IVF again? What surgery would you recommend (if any) with the shortest recovery time? I would like to resume IVF as soon as possible. What is the recovery time where I should rest before resuming IVF treatment?

Please see the report from the scan below -
Transvaginal sonography of the pelvis was performed and the following observations were made. Uterus appears mildly enlarged with heterogenous echotexture, showing multiple fibroids. Submucosalright lateral wall fundal fibroid - 54.8 x 52.9 mm, intramural anterior wall fibroids - 24.5 x 20.5 mm and 16.7 x 15.7 mm. Cervix appears normal. Endometrial echotexture appears normal. No fluid seen within the endometrial cavity. Right ovary shows a cyst (22.2 x 17.8 mm) with internal echoes - Probably collapsed follicle. Left ovary shows few tiny immature follicles measuring 12.5 x 10.2 mm, 8.9 x 7.6 mm, 8.8 x 7.5 mm, 7.4 x 6.4 mm. Free fluid seen in both adnexae.
IMPRESSION: Heterogenous texture Uterus with fibroids.

I also have images of the scans if that would be helpful so that you can see where they are situated.

Thank you for this response. I wasn't totally clear about the recovery time. I just want to check is the recovery up to 8 weeks after the surgery then a further up to 8 weeks before I can restart IVF (making a total of up to 16 weeks)? Or can I start IVF up to 8 weeks after the surgery? Just wanted to seek clarification.

I have some questions to follow up. There are different types of myomectomy and some are suitable or even unsuitable for different types of fribroids. Which type of myomectomy do you feel I should do given the type of fribroids I have? Please explain your answer as this area is very new to me. I'd like to be able to know what type of surgery I should be seeking and ideally have a quick recovery time bearing in mind the type of fibroids I have. Thanks in advance.

Thank you for this. Things are becoming a bit clearer. How does the laparoscopic myomectomy compare to fribroids embolisation in terms of which method might suit me? Also, can you recommend any consultants who can carry out either procedure please? I would like to resume IVF as soon as possible.

Kindest regards,