Being told that you have uterine fibroids can be worrying if you are planning a pregnancy. You may wonder whether fibroids will prevent conception or whether you need surgery before trying to conceive.
Many people with fibroids become pregnant, and not every fibroid needs treatment. The effect on fertility depends partly on the fibroids' size, number and location.
1. What Are Uterine Fibroids?
Uterine fibroids, also called leiomyomas or myomas, are non-cancerous growths that develop in or around the muscular wall of the uterus.
They vary in size and location. Some cause heavy periods or pelvic pressure, while others produce no symptoms and are discovered during a routine ultrasound.
2. Can Fibroids Affect Fertility?
Some fibroids can affect fertility, but many do not.
Their impact depends on where they grow:
Submucosal fibroids: These grow towards or into the uterine cavity and can distort the space where an embryo implants. They are more likely to be relevant to fertility.
Intramural fibroids: These grow within the muscular wall of the uterus. Their significance depends on factors such as size and whether they distort the cavity.
Subserosal fibroids: These grow on the outside of the uterus and are generally less likely to affect fertility when they do not distort the uterine cavity.
Fibroids may also be associated with pregnancy complications in some circumstances. However, finding a fibroid does not automatically mean it is the cause of infertility.
3. What Are the Symptoms of Fibroids?
Some people have no symptoms. Others may experience:
Heavy or prolonged menstrual bleeding.
Painful periods.
Pelvic pressure or discomfort.
Frequent urination.
Lower abdominal fullness.
Pain during sex.
Difficulty conceiving in some cases.
Heavy bleeding can sometimes cause iron-deficiency anaemia. If your periods are very heavy, you feel dizzy or faint, or your symptoms interfere with daily life, seek medical advice.
4. How Are Fibroids Diagnosed?
A clinician may recommend a pelvic examination and ultrasound. Additional tests may be considered if more information about the uterine cavity is needed.
The appropriate investigation depends on your symptoms, reproductive history and the location of the fibroid.
If you are planning a pregnancy, ask your doctor whether the fibroid's location is likely to matter for conception or pregnancy.
5. Do Fibroids Need to Be Removed Before Pregnancy?
Not necessarily.
The decision depends on the fibroid's location, size, symptoms, impact on the uterine cavity, previous pregnancy history and your fertility goals.
A doctor may recommend monitoring if the fibroid is unlikely to affect fertility and is not causing significant symptoms. In other situations, treatment may be discussed.
Myomectomy is surgery to remove fibroids while leaving the uterus in place. It may be appropriate in selected cases, particularly when fibroids distort the uterine cavity. However, surgery has risks, and recovery may delay attempts to conceive. Scar tissue can also develop after surgery.
Do not assume that every fibroid must be removed before trying naturally or starting IVF. Ask your specialist to explain the expected benefits and risks in your specific case.
6. Can You Have IVF With Fibroids?
Yes, many people with fibroids can undergo IVF. The important question is whether the fibroids are likely to affect the uterine cavity, implantation or pregnancy, and whether any treatment is advisable before proceeding.
Your fertility specialist may review ultrasound findings and other relevant tests before recommending a plan. The best approach depends on the individual circumstances.
Frequently Asked Questions
Can small fibroids cause infertility?
Some small fibroids, particularly those that affect the uterine cavity, may be relevant. Size alone does not determine their impact.
Can I get pregnant naturally with fibroids?
Yes. Many people with fibroids conceive naturally. The effect depends on their location and other fertility factors.
Will removing fibroids improve fertility?
It may help in selected cases, particularly when fibroids distort the uterine cavity. Surgery is not beneficial or necessary for every person with fibroids.
Can fibroids cause miscarriage?
Certain fibroids may be associated with an increased risk of pregnancy complications, but the relationship depends on their characteristics and other factors. Discuss your individual risk with your doctor.
The Bottom Line
Fibroids do not automatically mean infertility. Their location and effect on the uterine cavity are often more important than simply knowing that they are present.
If you have fibroids and are planning pregnancy, a fertility specialist can help determine whether monitoring, treatment or further investigation is appropriate.
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Medical information disclaimer
This article is for general educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. It has not been medically reviewed by a Dream Baby doctor. Consult a qualified healthcare professional for individual guidance.
References
1. American College of Obstetricians and Gynecologists (ACOG). Uterine Fibroids. https://www.acog.org/womens-health/faqs/uterine-fibroids
2. American Society for Reproductive Medicine (ASRM). Fertility Evaluation of Infertile Women: A Committee Opinion. https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/