Is surgery a better option than observation?
The more practical and prudent course would be to plan surgery (myomectomy) as close to the desired pregnancy as possible, considering the recurrence rate of fibroids (approximately 25%) after myomectomy. There is also the potential risk of postoperative adhesion after myomectomy and the possible adverse effect it may have on fertility.
Adhesions tend to develop at the site of previous surgery (i.e., the area from which fibroids were surgically removed). Scarring develops in these areas, which can cause the adjacent organs (intestines, fallopian tubes, and ovaries) to become attached. This may lead to blockage of the tubes, swelling or inflammation of the tubes, and subsequently decreased fertility.