Fibroids can be one of the causes of fertility problems and recurrent miscarriages in women. This was the case for a patient who experienced multiple pregnancy losses before discovering that the underlying cause was a fibroid growing in a location that was difficult to access through conventional surgery.
The patient’s fibroid was located at the back of the uterus (posterior) and had already adhered to the intestine. This made surgical removal highly challenging. Approaching the fibroid from above carried the risk of damaging the uterine wall, while approaching it from behind posed the risk of injuring the intestine that was attached to the fibroid.
To address this complex condition, the patient eventually sought treatment at Mandaya Royal Hospital Puri, which offers High-Intensity Focused Ultrasound (HIFU), a non-surgical technology for treating fibroids.
“Because of its position, the fibroid was actually difficult to remove through laparoscopy. It was located behind the uterus and had already adhered to the intestine. If approached from above, it could damage the uterine wall. If approached from behind, we didn’t know whether the intestine would be affected or not. At first, I felt hopeless and wondered whether it could be treated. Then I found out about HIFU. It truly helped me, and everything went smoothly by God’s grace,” said the patient.
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Experiencing Recurrent Miscarriages Before Finding the Cause
The patient shared that she had been married since 2018. She became pregnant for the first time in 2023, but unfortunately the pregnancy ended in miscarriage because the embryo failed to develop.
Two years later, in 2025, she became pregnant again. Unfortunately, the second pregnancy also encountered complications. During the initial examination, the pregnancy was confirmed, but the gestational sac could not yet be seen. Shortly after returning home, she experienced bleeding.
When she returned for another examination, the doctor explained that such a condition can still occur during early pregnancy. A follow-up examination later showed that the gestational sac had begun to appear.
The patient was prescribed medication and advised to rest. However, the next day, the bleeding recurred, and the pregnancy could not be maintained.
Having experienced two miscarriages, the patient began searching for the underlying cause. After receiving recommendations from family members and discussing the matter with her husband, she decided to consult Dr. Edward Tony Ngantung, Sp.OG at Mandaya Royal Hospital Puri.
Examination Revealed Fibroids as the Main Cause
During a more thorough evaluation with Dr. Edward, it was discovered that the patient’s uterus was enlarged and contained several fibroids. After assessing the pregnancy, Dr. Edward concluded that the pregnancy could not continue and that the underlying condition needed to be treated first.
A comprehensive evaluation was then performed to determine the cause of the recurrent miscarriages. The results suggested that the uterine fibroids were the most likely factor contributing to the patient’s pregnancy losses.
According to Dr. Edward, multiple fibroids were identified, but the most significant one was approximately 5 cm in size and located in the posterior portion of the uterus.
“After conducting the examination, we found several masses, but the most significant was a 5 cm fibroid located on the posterior side of the uterus. Blood tests and semen analysis were all normal. Therefore, we suspected that the previous pregnancy failures could have been caused by the fibroid,” explained Dr. Edward.
Because the fibroid’s location was difficult to access through either conventional surgery or laparoscopy, Dr. Edward recommended HIFU treatment.
Why Do Fibroids Make It Difficult to Get Pregnant?
Fibroids can affect fertility and increase the risk of complications during pregnancy. Some of their effects include:
- Blocking the fallopian tubes, making it difficult for sperm and egg cells to meet.
- Interfering with embryo implantation due to changes in the shape or condition of the uterine cavity.
- Reducing the available space for fetal growth, particularly when the fibroid is large.
- Increasing the risk of placental abruption, a condition in which the placenta detaches prematurely from the uterine wall.
- Limiting the supply of oxygen and nutrients to the fetus due to impaired placental function.
- Increasing the risk of miscarriage and preterm birth, especially when fibroids are large or located in critical areas of the uterus.
HIFU for Non-Surgical Fibroid Treatment
HIFU (High-Intensity Focused Ultrasound) is a non-invasive treatment technology that uses high-intensity ultrasound waves to precisely destroy fibroid tissue without any surgical incision.
How HIFU Works
- Ultrasound waves are focused directly on the fibroid tissue.
- The generated heat gradually destroys the fibroid cells.
- Healthy surrounding tissues remain protected because the energy is concentrated only on the targeted area.
- The procedure is performed without incisions and without removing the uterus.
Advantages of HIFU
- No open surgery required.
- No surgical scars.
- Lower risk of bleeding.
- Faster recovery compared to surgery.
- Suitable for fibroids located in areas that are difficult to reach surgically.
- Helps preserve the uterus for women who still wish to conceive.
Considering the size and complex location of the fibroid, HIFU was chosen as the most appropriate treatment option. This technology provides new hope for patients whose fibroids are associated with high surgical risks while also helping preserve future fertility.
In fact, just one day after the HIFU procedure, the patient was able to get out of bed and walk normally. Thanks to the rapid recovery, she was discharged on the same day. Dr. Edward plans to conduct follow-up evaluations over the next one to three months.
Furthermore, Dr. Edward stated that the patient may be able to begin trying to conceive again within approximately three to six months after undergoing HIFU treatment.
Dr. Edward’s Profile and Practice Schedule at Mandaya Royal Hospital Puri
Dr. Edward Tony Ngantung, Sp.OG, is an obstetrician and gynecologist who provides comprehensive women’s healthcare services, ranging from preconception planning to the management of various gynecological conditions. He earned his medical degree from Sam Ratulangi University and completed his specialist training in Obstetrics and Gynecology at San Juan de Dios Educational Foundation. To meet Indonesian medical practice standards, he also completed an Obstetrics and Gynecology adaptation program at Udayana University.
In his clinical practice, Dr. Edward has experience in fertility planning, prenatal examinations and assessments, fetal imaging, contraceptive counseling, pregnancy-related complications, benign gynecological conditions, and minimally invasive procedures tailored to each patient’s needs.
Dr. Edward Tony Ngantung, Sp.OG practices at Mandaya Royal Hospital Puri on the following schedule:
- Monday: 2:00 PM – 4:30 PM
- Tuesday: 11:00 AM – 2:00 PM
- Wednesday: 5:00 PM – 8:00 PM
- Thursday: 5:00 PM – 8:00 PM
- Friday: 10:00 AM – 2:00 PM
- Saturday: 9:00 AM – 1:00 PM
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The information provided on this page is intended for educational and general informational purposes only and may not reflect the full range of medical services offered by each physician. To receive treatment tailored to your specific condition, please consult directly with the relevant doctor.
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