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What Are Uterine Fibroids?
Uterine fibroids are benign growths made of muscle tissue that form in or around your uterus. Also known as myomas or leiomyomas, they develop when a single muscle cell in the uterine wall multiplies and grows into a benign tumour. These growths can range from the size of a seed to as large as a melon, and you might have just one or several. Fibroids can also change the shape or size of your uterus or even affect the cervix (the lower part of the uterus).Fibroids are categorised according to their location in the uterus:
- Subserosal fibroids: These form on the outer wall of the uterus and are less likely to impact fertility.
- Intramural fibroids: Located within the muscular layers of the uterine wall. These can affect fertility if they grow large.
- Submucosal fibroids: These extend into the uterine cavity and are most likely to cause fertility issues.
- Pedunculated fibroids: These grow on stalks and can either extend into the uterine cavity or outside the uterus. In simple words, they are attached to the uterus by a thin stem, like a little mushroom on a stalk. Such types can cause pain if they twist.
How Fibroids Can Impact Fertility
Not all fibroids cause fertility problems. Many individuals with fibroids conceive naturally without issues. However, about 5 to 10 per cent of people struggling with infertility have fibroids, and certain types, sizes, or locations can make conception more challenging. This is how fibroids might affect your ability to get pregnant:- Changes to the cervix shape: Fibroids can alter the cervix’s structure, reducing the number of sperm that can enter the uterus to reach the egg.
- Blocked fallopian tubes: Large fibroids near the fallopian tubes can compress or block them. This prevents sperm from meeting the egg or stopping a fertilised embryo from reaching the uterus.
- Altered uterine cavity: Submucosal or large intramural fibroids can distort the uterine cavity’s shape or size.
- Reduced blood flow: Fibroids can disrupt blood flow to the uterine lining, creating a less hospitable environment for an embryo to implant or develop.
- Hormonal imbalances: Some fibroids grow due to excess oestrogen, which can interfere with ovulation and disrupt your menstrual cycle.
Symptoms of Fibroids That Might Signal Fertility Issues
They don’t always cause symptoms, and you might only discover them during a pelvic scan. However, certain symptoms could signal that fibroids are affecting your fertility:- Fibroids can cause unpredictable, heavy, or painful menstrual bleeding.
- If you’ve been trying to get pregnant for a while without success, fibroids could be a factor.
- Pelvic pain or a feeling of fullness in your lower abdomen could mean fibroids affecting the uterus.
- Large fibroids pressing on the bladder can make you feel the need to urinate often.
- You may experience pain during intercourse if they’re large or located near the cervix.
Diagnosis of Fibroids
If fibroids are suspected, your doctor will likely recommend diagnostic tests to confirm their presence:- Pelvic examination: A physical check to detect any irregularities in the uterus’s size or shape.
- Ultrasound: This imaging test visualises fibroids and their location in the uterus.
- Advanced imaging: In some cases, an MRI, hysterosalpingography, or saline-infused sonography may be used to get a clearer picture of fibroid size, number, and position.
Fibroid Treatment Options to Improve Fertility
Your healthcare professional may suggest the following treatment options:1. Medications
- Hormonal therapies, like Gonadotropin-Releasing Hormone (GnRH) agonists, can shrink fibroids by reducing oestrogen and progesterone levels. These are often used before surgery but may temporarily stop ovulation, so they’re not ideal if you’re actively trying to conceive.
- Low-dose birth control pills or progesterone injections can control heavy bleeding but don’t directly improve fertility.
- Anti-inflammatory drugs can ease pain, but these don’t address fibroid size or fertility issues.
2. Surgical Procedures
- Myomectomy: This surgery removes fibroids while preserving the uterus. It can be the ideal option for people wanting to conceive. The procedure is done via laparoscopy (small abdominal incisions), hysteroscopy (through the vagina and cervix), or open surgery.
- Uterine artery embolisation (UAE): This minimally invasive procedure blocks the blood supply to fibroids and causes them to shrink. However, it’s not always recommended for individuals planning pregnancy as it may affect uterine blood flow and fertility.
- MRI-guided focused ultrasound surgery (FUS): This uses high-intensity ultrasound waves to destroy fibroid tissue. But its impact on fertility is less studied, so it’s not commonly used for people trying to conceive.
3. Lifestyle Changes
- Following a diet rich in fruits, vegetables, and whole grains while avoiding processed foods may help you manage symptoms.
- Keep a healthy weight through regular exercise to balance your hormones and reduce fibroid-related issues.
4. Assisted Reproductive Technologies (ART)
Treatments like IVF can help you conceive if you have fibroids. However, some fibroids can make IVF less successful by affecting implantation. So consider removing them before fertility treatments for a healthy pregnancy.Can Fibroid Removal Improve Fertility?
If fibroids are the primary cause of your infertility, removing them can help. Myomectomy can be effective because it preserves the uterus for future pregnancies. But infertility can have multiple causes, so your doctor will evaluate other factors as well to make sure fibroids are the main issue. If fibroids are small or in less problematic locations, your doctor might recommend proceeding with fertility treatments without removal.If you’ve just discovered you have fibroids, know that they may create challenges in your TTC journey, but they don’t always stop pregnancy. Understanding how their size, location, and type affect your fertility is key to making informed decisions.
Whether you’re trying to conceive or navigating IVF, you’re not alone. Join our supportive communities to connect, share, and find strength with others on the same journey.
FAQs on Can Fibroids Affect Your Fertility?
- Can I get pregnant with fibroids?
Yes, you can get pregnant with fibroids. Many individuals with fibroids conceive naturally if the fibroids are small or located away from the uterine cavity. But those located inside the uterine cavity or near the fallopian tubes can make it harder to conceive. - How to improve fertility with fibroids?
If fibroids are affecting your fertility, doctors may suggest treatments like surgery to remove them. Maintaining a healthy weight, managing stress, and regular checkups also support fertility.