Fibroids & Fertility

January 25, 2024
In vitro fertilization (IVF)
Fertility

Did you just have a pelvic scan that revealed uterine fibroids? Did your doctor tell you the reason for those painful periods could be uterine fibroids? Fibroids are non-cancerous growths that can interfere with a woman’s menstrual cycle or fertility. Fibroids are not uncommon, especially among women of reproductive age. The exact cause of such fibroids is still not clear. Different types of fibroids have different impacts. Read on to know more.

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What Are Fibroids?

Fibroids in women are non-cancerous tumors made of muscle tissue that form in the uterus. Also known as myomas or leiomyomas, these fibroids occur when a single muscle tissue multiplies and grows to form a tumor.

Uterine fibroids can form in different shapes and sizes. They can be a single tumor or clusters of tumors. In many cases, the uterus will have more than one fibroid. They can form in various parts of the uterus too.

While some fibroids can cause immense pain or excess bleeding during menstrual cycles, some fibroids will have no symptoms. You may not know of their existence until you take a pelvic scan.

Types of Fibroids

Fibroids come in various shapes and sizes. They are categorized based on where they form in the uterus. The different types of uterine fibroids in women are:

  1. Subserol Fibroids – These fibroids form on the outer wall of the uterus.
  2. Intramural Fibroids The fibroids are found in the uterine wall’s muscular layer. They can form in between the uterine muscles.
  3. Submucosal Fibroids – These fibroids form just under the uterine lining, and protrude into the endometrial cavity.
  4. Pedunculated Fibroids – Some fibroids will grow on stalks that attach to the uterine wall. They can protrude into the uterine cavity or even twist on the stalks, causing pain during menstrual cycles.

Sometimes the fibroids that grow on the outer uterine wall can attach to the nearby organs or ligaments. In very rare cases, you can also find fibroids outside the pelvic cavity.

Impact of Fibroids on Fertility

When a woman is unable to conceive, the doctor always checks for fibroids along with the egg reserve, menstrual cycle, etc. Not all fibroids affect a woman’s fertility. Some fibroids may grow as the pregnancy progresses but will not interfere with the pregnancy in any way.

Almost 10% of the women suffering from infertility have fibroids. The location and the size of the fibroids determine their effect on a woman’s fertility. Fibroids that grow within the

uterine walls and are more than 6cm in diameter can affect fertility. Similarly, fibroids that grow inside the uterine cavity can also affect infertility.

Fibroids can lead to infertility or impact fertility in the following ways:

  • The shape, size, and position of the fibroid can change the shape of the uterus. This in turn can interfere with the sperm’s movement towards the egg or the movement of an embryo to the uterus.
  • If the fibroid changes the shape of the cervix, it can reduce the number of sperm that enter the uterus to meet the egg
  • Fibroids can block the fallopian tubes and prevent conception
  • Fibroids can impact the size of the uterine cavity lining – which is important for implantation
  • Fibroids can reduce the amount of blood flow to the uterus, thus affecting the ability of an embryo to attach to the uterine wall

Fibroid Removal And Fertility

Now, this brings us to the next question – can removing fibroids improve one’s fertility?

Fibroids do not always interfere with fertility. Infertility can have multiple reasons. So, if a doctor suspects a fibroid growing in a wrong location or too big in size, could be impacting your fertility, the first step is to remove it. If your infertility was only due to the fibroid and not due to anything else, then removing the fibroid without hurting the uterus, can improve your fertility.

Fertility Treatments With Fibroids

In some cases, when fibroids are not the reason for infertility, the fertility specialist will evaluate other possibilities. If the fibroids are not too big or in a dangerous location, there is no need to remove them. A well-trained fertility specialist can discuss with your gynecologist and identify the best fertility treatment options to improve your fertility despite the fibroids.

Complications Of Fibroids During Pregnancy

In many cases, when the fibroids do not cause any issues with a woman’s menstrual cycles, she does not realize their existence until she takes a pelvic scan. Most times, this is during a pregnancy scan. If the fibroid does not grow in size or interfere with the growth of the fetus, there is nothing to worry about. In many cases, such fibroids form during pregnancy and go away or shrink after delivery.

In some cases, the fibroid can grow through the pregnancy and increase in size just like the baby. When the fibroid grows within the uterine cavity, it can decrease the space for the baby to grow in. As a result, it can affect fetal growth or even lead to preterm delivery. In very rare cases, when the risk is high, the doctor might perform surgery during pregnancy, to remove the fibroid.

Conclusion

Fibroids can cause a lot of discomfort and problems if they are too big or in the wrong place. You need not suffer from excess pain, bleeding, or infertility due to such fibroids. Find a good gynecologist with sufficient experience in handling fibroids and you can overcome fertility issues too.

FAQs

1. Can you get pregnant if you have fibroids?

Yes, many women with fibroids go on to have successful pregnancies, free of complications. Fibroids of certain sizes in certain locations can impact your pregnancy chances and outcomes. If your fibroids are causing infertility, consult a gynecologist. They can help you with appropriate treatment or suggest surgery to remove the fibroids.

2. What size of fibroid can prevent pregnancy?

A fibroid of more than 6cm can impact pregnancy. Sometimes even small fibroids or clusters of fibroids growing in the fallopian tube, protruding into the uterine cavity, or growing in the cervix can prevent pregnancy. It is not just the size but the location of the fibroid also matters.

3. How do you know if fibroids are causing infertility?

If you have fibroids and are having difficulty getting pregnant, you should consult your gynecologist. They can check if the fibroids are responsible for your fertility issues. You should also consult a fertility specialist to confirm if the fibroids are causing infertility.

4. Can fibroids affect your menstrual cycle?

Yes, fibroids can affect your menstrual cycle. It can cause you to skip your periods one month and bleed a lot the next month. For some women, the fibroids can increase both pain and bleeding during menstruation, every cycle.