How fibroids affect pregnancy and fertility
Uterine fibroids are benign tumours that grow in or on the uterus. They may or may not impact fertility and pregnancy chances.
Fibroids can sometimes stop a woman from becoming pregnant and can create problems for the fertilized egg attaching to the lining of the uterus. Some fibroids grow inside the uterus (submucosal fibroids), changing the shape of the uterus and making it harder to get pregnant or to carry a pregnancy to term.
Fibroids can make sexual intercourse painful for the woman. There are various surgical and non-surgical methods to treat fibroids, but special care should be taken to preserve fertility, especially in women who still have plans of conceiving and having children in the future.
Uterine fibroids are very common. About 20 to 80 percent of women develop these noncancerous growths by age 50, and 30 percent of women between 25 and 44 have symptoms of fibroids. That means uterine fibroids are common during a woman’s childbearing years.
Fibroids may increase your risk for other complications during pregnancy and delivery. The majority of fibroids don’t change in size during pregnancy, but some do. Still, for other women, fibroids may actually shrink during pregnancy.
You may not have any of the typical symptoms of fibroids, but if you do have symptoms, the most common include heavy or painful periods, bleeding between periods (spotting), anemia from heavy or long-term bleeding, prolonged periods, feeling “full” or a mild pressure in your lower abdomen, pain during sex, among others.
Fibroids may be felt during a pelvic exam. If your doctor suspects you have the noncancerous growths, he may order an imaging test, such as an ultrasound, to confirm the growths are indeed fibroids and not something else.
Effects of fibroids on fertility are well documented. Many women who have fibroids can get pregnant naturally. Treatment may not even be necessary for conception.
In some cases, however, fibroids can impact your fertility. For example, submucosal fibroids, which are a type of fibroid that grows and bulges into the uterine cavity, increase your risk for infertility or pregnancy loss.
While fibroids may cause infertility for some women, other explanations for infertility are more common. If you’re having trouble conceiving or maintaining a pregnancy, your doctor may explore other possible causes before attributing the issue to fibroids.
If you’re trying to conceive with fibroids, talk with your doctor about the size or position of any fibroids you have and ask if they could cause problems with your attempts to get pregnant or the ability to carry a pregnancy. It is important to find out if fibroid treatments can help improve your odds for pregnancy success.
Now, how are fibroids treated before pregnancy to improve fertility?
Treating uterine fibroids before pregnancy may improve your fertility. The most common treatments for fibroids that preserve fertility include open myomectomy, laparoscopic myomectomy, and the use of high intensity focused ultrasound (HIFU) which is a non-invasive and safe treatment method.
A surgical treatment, called myomectomy can remove the fibroids, while saving the uterus and the ability to get pregnant. Myomectomy however caries the risk of uterine scars or adhesions which in turn can make implantation difficulty. It should therefore be performed by a skilled surgeon to avoid this potential complication.
If you are pregnant, but have undiagnosed fibroids, you may deliver prematurely or lose the baby through a miscarriage. The fibroids interfere with the baby’s development.
Fibroid growth may increase your need for Cesarean delivery, and you’ll likely need to wait a few months following the procedure before attempting to conceive.
Gonadotropin-releasing hormone (Gn-RH) agonists are a type of medication that block the production of the hormones that lead to ovulation and menstruation, so you won’t be able to become pregnant while taking this medication. It can help shrink fibroids.
Other treatments are available if you are with fibroids and want to preserve your fertility.
Uterine fibroids may affect your fertility. They may also impact your ability to carry a pregnancy successfully. However, most women will experience no fertility issues or pregnancy complications as a result of these tumours.
If you have fibroids and wish to start a family, talk with your doctor about your options for treatment and your risks. Together, the two of you can decide what’s safest for your future pregnancy.
While you can’t prevent fibroids, a healthy lifestyle may lower your risk. Likewise, a healthy lifestyle, which includes maintaining a healthy weight, may lower your risk for fertility issues and high-risk pregnancies.
MD/CEO Nordica Fertility