Can Uterine Fibroids Affect Fertility? Insights and Medical Advice

Uterine fibroids—also known as leiomyomas or myomas—are non-cancerous growths that develop within or on the uterus. Affecting approximately 20-40% of women during their reproductive years, these growths vary in size, number, and location. While many women with fibroids conceive and carry pregnancies successfully, in some cases, fibroids can impact fertility and complicate pregnancy outcomes. Understanding the relationship between uterine fibroids and fertility is essential for women planning to conceive.

Understanding Uterine Fibroids: What Are They?

Uterine fibroids originate from the smooth muscle layer of the uterus and can be classified based on their location:

• Submucosal fibroids: Develop just beneath the uterine lining and may protrude into the uterine cavity.
  
  
• Intramural fibroids: Grow within the muscular wall of the uterus.
  
  
• Subserosal fibroids: Extend beyond the outer uterine wall into the pelvic cavity.
  
  

These benign tumors are estrogen-sensitive and tend to grow during a woman’s reproductive years. Factors such as genetics, obesity, and early onset of menstruation increase the risk of developing fibroids.

How Uterine Fibroids Affect Fertility

While many women with fibroids experience no fertility problems, certain types and sizes of fibroids can impair a woman’s ability to conceive or maintain a healthy pregnancy.

1. Disruption of Implantation

Submucosal fibroids, especially those that distort the uterine cavity, can hinder embryo implantation. When the fibroid interferes with the endometrial lining, it can prevent a fertilized egg from embedding itself securely, leading to failed conception attempts.

2. Tubal Obstruction

In some cases, fibroids near the uterine cornua may block the fallopian tubes. This blockage prevents sperm from reaching the egg or hinders the fertilized egg’s journey to the uterus, affecting fertility outcomes.

3. Reduced Blood Flow to Uterine Lining

Large or multiple fibroids can compete with the endometrial lining for blood supply. This may reduce the uterine lining’s receptivity, making it difficult for the embryo to implant or develop properly.

4. Hormonal Imbalance and Menstrual Irregularities

Fibroids can lead to hormonal imbalances, affecting ovulation and the regularity of menstrual cycles. This can complicate efforts to track fertility windows and impact successful conception.

Fibroids and Pregnancy Complications

Fibroids, particularly those that grow large or are located near the uterine cavity, can increase the risk of several pregnancy-related complications:

• Recurrent miscarriage: Studies show that women with untreated fibroids have a higher risk of pregnancy loss, especially in the first trimester.
  
  
• Placental abruption: Fibroids may compromise the placenta’s attachment, leading to early detachment and pregnancy loss.
  
  
• Preterm labor: Pressure from fibroids can irritate the uterus and trigger early contractions.
  
  
• Malpresentation: Large fibroids may alter the shape of the uterus, making it difficult for the baby to assume a head-down position.
  
  
• Cesarean delivery: Women with significant fibroid burden are more likely to require a cesarean section due to labor complications or obstructed delivery pathways.
  
  

Recognizing Symptoms that May Affect Fertility

While some women remain asymptomatic, others experience signs that could indicate fibroids are affecting their fertility:

• Heavy or prolonged menstrual bleeding
  
  
• Pelvic pressure or pain
  
  
• Frequent urination or constipation due to fibroid pressure on pelvic organs
  
  
• Difficulty conceiving despite regular unprotected intercourse
  
  
• Recurrent early pregnancy loss
  
  

Women experiencing these symptoms should seek a thorough evaluation by a gynecologist.

Diagnosis: Identifying Fibroids Affecting Fertility

Diagnosis typically involves:

• Pelvic examination: May reveal an enlarged, irregular uterus.
  
  
• Ultrasound: Transvaginal or abdominal scans can determine fibroid size and location.
  
  
• MRI: Provides detailed imaging for complex cases.
  
  
• Hysterosonography or Hysteroscopy: Helps assess uterine cavity abnormalities and guides treatment planning.
  
  

An accurate diagnosis is essential to determine the most appropriate management strategy for women who wish to conceive.

Effective Treatment Options to Restore Fertility

Treatment depends on the fibroid’s characteristics, the woman’s symptoms, and her desire for future fertility. Common treatment strategies include:

1. Myomectomy

This surgical procedure removes fibroids while preserving the uterus. It is the preferred option for women desiring pregnancy, especially for those with submucosal or large intramural fibroids. Studies show improved fertility outcomes following myomectomy.

2. Uterine Artery Embolization (UAE)

This minimally invasive procedure blocks blood flow to the fibroids, causing them to shrink. However, UAE is generally not recommended for women actively trying to conceive, as it may impair uterine function and reduce fertility.

3. Hormonal Therapy

Medications such as gonadotropin-releasing hormone (GnRH) agonists can shrink fibroids temporarily by inducing a low-estrogen state. These are typically used preoperatively or when surgery is not immediately feasible.

4. MRI-Guided Focused Ultrasound Surgery (MRgFUS)

A non-invasive technique using high-frequency sound waves to destroy fibroid tissue. Though promising, it is not yet widely recommended for women seeking pregnancy due to limited long-term fertility data.

Assisted Reproductive Technologies and Fibroids

Impact on IVF Success Rates

Fibroids that distort the endometrial cavity can lower in vitro fertilization (IVF) success by impairing embryo implantation and increasing miscarriage risk. Submucosal and large intramural fibroids are particularly detrimental.

Treating Fibroids Before IVF

For women undergoing ART, removing fibroids before IVF significantly improves outcomes. Consultation with both a fertility specialist and a gynecologist ensures that any underlying uterine abnormalities are addressed prior to initiating fertility treatment.

When to Seek Medical Advice

If you are:

• Experiencing unexplained infertility
• Have had multiple miscarriages
• Diagnosed with fibroids and planning a pregnancy
• Facing menstrual irregularities or pelvic pain

you should consult a qualified gynecologist promptly. Early diagnosis and personalized treatment can significantly improve your reproductive outcomes.

Conclusion: Empowering Your Fertility Journey

While uterine fibroids can sometimes interfere with conception and pregnancy, many women successfully conceive and carry healthy pregnancies with the right diagnosis and management. Understanding how fibroids affect fertility is the first step toward overcoming potential challenges.

If you’re concerned about your fertility or have been diagnosed with fibroids, take proactive steps and consult a specialist. With professional care, advanced treatment options, and personalized support, your journey to parenthood remains very much within reach.

At Silver Nest Clinic, under the expert guidance of Dr. Shweta Bansal Wazir, we provide comprehensive care for women affected by uterine fibroids and fertility challenges. From accurate diagnosis to advanced surgical and non-surgical treatments, our clinic ensures each woman receives a tailored approach to restore and protect her fertility.

📞 Book a consultation today: +91 84481 28007
🌐 www.drshwetawazir.com