December 9, 2024
Fibroids and fertility. It’s a common question that a lot of sufferers want to get an answer to - will fibroids stop me from getting pregnant?
Will I have a healthy child? Will my pregnancy go smoothly?
We’ve looked through the research and have broken it down in an easy-to-understand way.
What are Fibroids?
Fibroids are small growths in the uterus. They aren’t considered dangerous, aren’t cancerous, but can cause discomfort and pain. They can grow as a single node or a cluster, can range in size from 1cm up to 20cm in diameter.
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They are fairly common, with around 25% of women being affected by them. There are 3 major types of fibroids:
- Intramural fibroids - these grow in the wall of the uterus itself.
- Subserosal fibroids - these are the most common type of fibroid and start as intramural before projecting outside the uterus.
- Submucosal fibroids - these fibroids are uncommon, and grow inside the uterus and project into the space where a baby grows during pregnancy.
Sometimes, fibroids can have a stalk that attaches to the uterus - these are called pedunculated and they are the least common type of fibroid.
How do Fibroids Affect Fertility?
Fortunately, most women who have fibroids can fall pregnant naturally.
However, fibroids can be found in about 10% of infertile women and may be the cause of infertility in about 1-2%. So even if you do have fibroids, the chance of them affecting your ability to conceive is low.
It’s important to note that the issue of whether fibroids cause infertility is largely misunderstood, mostly due to a lack of scientific evidence and studies.
However, one study conducted back in the late 90s found something interesting.
The researchers studied 212 women and found that infertility rates in those with fibroids was 11%. In those without fibroids, it was 25%.
However, these numbers change pretty dramatically once the fibroids were removed. Pregnancy rates went from 25% to 42%, which suggests that fibroids do indeed impact fertility and the ability to fall pregnant.
How Can Fibroids Cause Infertility?
For those small percentage of women who are having trouble conceiving because of fibroids, ReproductiveFacts.org list the following possible issues:
- Changes in the shape of the cervix can affect the number of sperm that can enter the uterus.
- Changes in the shape of the uterus can interfere with the movement of the sperm or embryo.
- Fallopian tubes can be blocked by fibroids.
- They can impact the size of the lining of the uterine cavity.
- Blood flow to the uterine cavity can be affected. This can decrease the ability of an embryo to stick (implant) to the uterine wall or to develop.
It’s usually about the location of the fibroids. Research has shown that the critical factor in whether fibroids will cause fertility or not is the size and location, particularly whether they are protruding into the uterine cavity.
Fibroids and Pregnancy
If you fall pregnant and have fibroids, it’s not common to be seriously affected by your fibroids, but there are some exceptions.
It has been shown that fibroids can grow during pregnancy. Data is limited, but one study found that 71% of fibroids grew during the first and second trimesters, and 66% grew between the second and third.
As previously mentioned, your chances of having fibroids affect your pregnancy or ability to conceive come down to size and location. Fibroids larger than 3cm are likely to cause problems, but it is still possible for women with fibroids up to 10cm to have a vaginal birth.
According to Samir Babayev, M.D, a fertility and reproductive surgeon and IVF clinic director at Mayo Clinic, “among other issues, fibroids may cause the placental attachment abnormalities, restrict the growth of the baby, increase the risk of preterm delivery, and bottom-down instead of head-down presentation at the time of delivery.”
Fibroids can cause complications in 10-40% of pregnancies, and they contribute to miscarriage, cesarean section, premature labor, malpresentation of the fetus, and postpartum hemorrhage.
Pregnancy loss can also be caused by fibroids. Both submucosal and intramural fibroids can significantly increase the risk of spontaneous abortion, and lower the rate of live birth.
What Can You Do About Fibroids Before Falling Pregnant?
If you are considering falling pregnant and have been diagnosed with fibroids, it’s best to speak with your GP or specialist who diagnosed you to discuss your situation. It’s clear from the evidence that fibroids, depending on their size, location and quantity, can cause infertility and lead to complications during pregnancy. Removing them may be the best course of action before trying to conceive.
Further Reading
If you want to learn more about fibroids and fertility, the following are peer-reviewed articles we recommend.
The Impact and Management of Fibroids for Fertility: an evidence-based approach
The role of leiomyomas in infertility
Uterine myomas during pregnancy: a longitudinal sonographic study
In Summary
Your chances of having infertility be directly caused by fibroids is low, around 1-2% of women can attribute infertility to fibroids. So for the majority of women diagnosed with fibroids, you still have a very good chance of falling pregnant.
Complications can arise during pregnancy caused by fibroids, however, and this is why we recommend speaking with someone about removing your fibroids. Not only does this reduce the risk of complications caused by these growths, it has also been shown to boost fertility.
Book a consultation today and let's discuss how Northern Beaches Interventional Radiology can treat your fibroids and put you on the path to a successful pregnancy.
