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.