I'm a 42 yr old women that received a abnormal result on my EFT.  Per my fertility specialist, everything else looks good for conception.  He's going to start me on Lupron for 3 months and take the EFT test again.  I would like to try IVF.  What's my chances successful IVF conception if I have an abnormal EFT result again?  

Analysis:  Ensuring the health of the uterus and the lining (the endometrium) is obviously important to anyone trying to conceive.  There are many ways of doing this evaluation but there are very few ways that are generally accepted.  This lack of acceptance is either because of inconsistencies in the test, lack of proof (validity) that the test identifies a true problem or the test offers no help in directing treatment. The general rule of thumb is that a test should be done only if the results will change what you do.  

IVF is a very successful treatment but a healthy uterus is needed.  If the lining cannot  be "normalized" then alternatives (adoption, gestational carrier, etc) should be considered.  - Ben Gocial, M.D.

Analysis:  If pregnancy is your goal then the "wait and see" option has its limits and those limits are based mostly on your age.  A women aged 35 and under should seek help if not pregnant by 12 months unprotected intercourse. 

A women over 35 or who has some other obvious problem should seek a physician's help by 6 unsuccessful months attempting conception.  It's often misleading and confusing to rely on the interpretation of symptoms.  It will pay to get the help you need.  - Ben Gocial, M.D.

Can you tell me if a fibroid that grew from 1.6cm to 3cm in two years is significant?  Is it common for it to disappear?

Analysis: First, fibroids are common occurring in up to 20 % of general female population (varying among different ethnic populations).

Secondly, most women with fibroids will not need any treatment and will suffer few if any consequences from those fibroids. This makes your question about significance difficult. It may be mathematically significant to grow from 1.6cm to 3.0cm, but at these sizes it's probably not clinically significant which means it's unlikely to cause any problems for or to the woman.

Thirdly, the significance (clinical) of fibroids is determined by the number, size and perhaps most importantly, location of the fibroid(s) present. Even a fibroid measuring the original size of 1.6 cm might cause serious problems (bleeding and/or pain) if it's located in the uterine cavity.

Lastly, fibroids are technically tumors, almost always benign, which grow from the cells of the uterine wall. They tend to develop and grow through out the woman's reproductive life. They are usually stimulated by the hormones of pregnancy, growing sometimes quickly and to a dramatic degree during the pregnancy and decreasing in size afterwards. After menopause, when the reproductive hormones are reduced or gone, the fibroids decrease in size and may after years of being menopausal "disappear". - Ben Gocial, M.D.

I believe my fibroids have come back after UAE and I want to be cured and get pregnant.

Analysis: As familiar with fibroids as I'm sure you are, there are a few things I would like to emphasize.

First there is no "cure" for fibroids other than hysterectomy. UAE, myomectomy and other treatments are meant primarily to deal with the fibroids you have at the moment. These treatments cannot prevent other fibroids from developing and growing.

Secondly, no matter what the common wisdom dictates, everyone is different and everyone deserves a detailed personalized evaluation.

Since the goal is to get pregnant, you have several issues to deal with; recurrent fibroids, age, and previous UAE. Several tests are needed to see what if any treatment options exist for you. You should have an appropriate evaluation. It may be that your doctors advise is appropriate for most patients in your situation but might not apply to you. - Ben Gocial, M.D.