Fibroids, Fertility, And Pregnancy

Updated: Jan 22, 2020

You might not know this, but uterine fibroids could be the reason you’re unable to conceive. But – wait, what are those? Well, if you haven’t heard of the term before, you’ll want to learn more about uterine fibroids ASAP – particularly since a majority of women will have them at some point in their lives. Below, find out what uterine fibroids are, their relationship with fertility and pregnancy, and how you can best treat them.


What are uterine fibroids?


Uterine fibroids, also medically known as fibromyomas, are benign tumours that grow from the uterus’ muscle wall. These can range in size – from 1 mm (a coin) to 8 inches in diameter (nearly twice the size of a uterus) – and can exist on their own or in multiples, potentially causing your uterus to expand and distend your belly. They tend to calcify after menopause – thus the name, ‘calcified fibroids.’ As scary as that sounds, though, you can breathe a sigh of relief; fibroids aren't associated with an increased risk of ovarian cancer and rarely develop into cancer.


Also, based on the location of growth, fibroids are classified into four categories:

  1. Intramural fibroids grow within the wall of the uterus.

  2. Subserosal fibroids grow on the outside of the uterus.

  3. Submucosal fibroids grow right under the lining of the uterine cavity.

  4. Pedunculated fibroids grow on a stalk either inside or outside of the uterus.


What are the symptoms of fibroids?


Most women with fibroids experience no symptoms and may not even realise that they have them until they get an ultrasound. But if you think that you may have them, here are some signs of fibroids to look out for:

  • Heavy bleeding during menstruation

  • Prolonged and/or painful periods

  • Pelvic pain or pressure

  • Lower back pain

  • Painful sex


Fibroids and fertility


Depending on their location and size, certain fibroids may cause fertility complications in the following ways:

  • Large or subserosal fibroids that alter the structure of the uterus can interfere with the movement of the sperm and/or the fertilised egg and prevent implantation.

  • Submucosal fibroids. These types of fibroids may divert blood flow from the endometrium, preventing it from thickening, and thus, impeding the implantation of a fertilised egg or the development of an embryo.


Fibroids and pregnancy


Although many women with fibroids have a smooth pregnancy, some do develop pregnancy-related complications, including:

  • Miscarriage. Research shows twice the risk of spontaneous miscarriage in women with fibroids (14%), compared to those without (7.6%).

  • Bleeding. Can fibroids cause bleeding? Well, yes – studies have shown a higher risk of bleeding (60%) in early pregnancy if the placenta is implanted close to the fibroid, compared to when there is no contact between the two (9%).

  • Increased chance of C-section. Having fibroids has been linked to an almost four-fold increased chance of having a caesarean section delivery, compared to women without.


Do fibroids need to be treated?


If you don’t present worrying symptoms, your doctor may just monitor the size of your fibroid(s). Sometimes, however, fibroids surgery – such as a myomectomy or uterine artery embolisation – may be recommended for fibroids that are causing moderate to severe symptoms or pregnancy complications. For example, if you suspect that your fibroids are contributing to fertility problems or recurrent miscarriages, you can talk to your doctor or fertility specialist about removing them. However, do note that it’s unclear if removing fibroids helps improve fertility or prevent miscarriages.


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