Uterine Fibroids & Fertility

Fibroids are very common in women of reproductive age with up to 80% of women experiencing fibroids during their lifetime.

Certain types of fibroids are known to affect fertility and your chance of conceiving. 

What is a Fibroid?

Fibroids are benign uterine growths, which may affect fertility:

  • In the uterine wall (intramural)
  • On the outer surface of the uterus (subserosal)
  • Protruding into the cavity of the uterus (submucosal)
What are the symptoms of Fibroids?

While many women are asymptomatic (have no symptoms) from their fibroids, the most common symptoms related to fibroids are:

  • Abnormal uterine bleeding
  • Pressure, because of the size and position
  • Pain, depending on the location and size
What causes fibroids?

It’s not known what causes fibroids. Nobody knows what causes fibroids. They just grow in the uterus and become more common as women get older.  They are more common in different parts of the world and are particularly common in African women.

Can fibroids affect your fertility?

Most fibroids do not affect a woman’s fertility. They are mostly found as incidental findings during an ultrasound scan and the vast majority have no effect and do not need any treatment. The important aspect is whether the fibroid is distorting the lining of the uterus, which most do not.

The only two situations where fibroids interfere with fertility are:

  • Where the fibroid is very large distorting the lining of the uterus
  • Where the fibroid is located inside the uterus itself (called a submucosal fibroid).

These would be two situations where surgery might be required to remove the fibroid. However, most fibroids do not need any treatment at all.

Whether fibroids affect your fertility, and therefore whether you need them removed, depends on both the size and location of the fibroids within the uterus.

If the fibroid is located on the inside of your uterus (submucosal fibroid) distorting or obstructing the uterine cavity or blocking the fallopian tubes, they are highly likely to be affecting your fertility by interfering with implantation, and most specialists would recommend their removal.

However if the fibroid does not affect the lining of the uterus, they have much less effect on your fertility and you may not need to have anything done about them.

Are there complications from fibroids?

While uterine fibroids aren’t usually dangerous, sometimes, very large fibroids can cause discomfort and might lead to complications such as anemia (a drop in red blood cells).

Anemia causes fatigue from heavy blood loss, and rarely, a transfusion might be needed to counteract the blood loss.

Pregnancy and fibroids: There are minimal to no complications from fibroids alone during pregnancy.

How are fibroids diagnosed?

Fibroids often go unnoticed, since they do not always cause symptoms. You may not know you have fibroids until you see your doctor – fibroids are usually found in a routine ultrasound scan as part of the investigation of infertility.

How do you treat Fibroids?

Fibroids may interfere with implantation of a developing embryo. Your fertility specialist would usually discuss the treatment option following a diagnosis and ultrasound.

If the fibroid is within the cavity of the uterus then a hysteroscopy may be required. If the fibroid is within the muscle of the uterus or outside the uterus, the treatment may be by surgical removal, by laparoscopy (keyhole surgery).

When should I see a doctor?

If you are struggling with your fertility, have persistent pelvic pain or pressure, heavy menstrual bleeding and painful periods, it is recommended that you see your doctor.

Fibroids and Fertility

Transcript

Can I get pregnant with fibroids? - Fertile Minds Video

My name is Dr. Haider Najjar. I'm a fertility specialist at Melbourne IVF.

So falling pregnant with fibroids is the question. And firstly, it's very important to know that fibroids are very, very common. Three to four out of 10 women walking on the streets may have fibroids and a lot of them fall pregnant and give birth without even knowing they have fibroids. So fibroids aren't always the evil people think they can be.

A lot of the fibroids are either sitting somewhere in the womb where they are irrelevant and they cause problems, or they may be small so in those cases we don't really worry about them at all. Fibroids can cause problems mainly if they were large, if there were numerous or if they sit in a crucial important area in the woman, particular the cavity of the womb or near the fallopian tubes where it may interfere with the ability to conceive or carry the pregnancy to term.

So the answer is yes, you can fall pregnant with fibroids and you may not even know that you had fibroids and that would be the ultimate scenario with fibroids. But if you have difficulty falling pregnant with fibroids or have problems with your menstrual cycle with fibroids so big and/or numerous whereas fibroids can cause pain.

They can cause heavy periods, they can cause difficulty conceiving, they can cause pressure on other organs like the bladder and cause problems with the urination or the bowels as well. In those cases, fibroids may warrant treatment and that we can attend to by medications or surgical procedures or either one nice of dealing with them.

It depends on the indication and the specific condition with the fibroid. Other than that, if fibroids are small or not that many of them around, or they're not interfering with their fertility or with the pain or with the periods, we better leave them alone and we don't need to do anything with them.

So that's your answer to fibroids and pregnancy. If you found this video helpful, please feel free to subscribe to the Fertile Minds channel and I'm sure you will find more information there in their future that might be useful.

*All opinions expressed on the Fertile Minds YouTube Channel belong to the individual doctors, scientists and specialists, not the Virtus Health group.

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