Fibroids Fertility: Challenges and Effective Treatment
Infertility is a disease of the reproductive system recognized by the failure to achieve pregnancy after 12 months of regular unprotected sex.
There can be many causes of infertility. But do fibroids affect fertility?
Uterine fibroids can be understood as the development of benign and non-cancerous tumors in the walls of the uterus.
Fibroids can cause various symptoms in women, including some that can affect their reproductive health, such as heavy periods.
This comprehensive article elaborates on the challenges and treatment for fibroids fertility and how they can improve their chances of getting pregnant.
Do fibroids affect fertility
The answer to this question is yes.
Out of all the significant causes of infertility, uterine fibroids are one of them.
As per a 2021 report, fibroids can be one of the causes of infertility in 2-3% of women.
Furthermore, as per the American Society for Reproductive Medicine, the size and location of fibroids significantly decide their effect on fertility.
How do fibroids affect fertility
Fibroids can affect fertility in the following ways:
- Fibroids can block the fallopian tubes and impair gamete transport
- Changes in the uterus shape can also affect the movement of sperm or embryo
- Changes in the shape of the cervix
- Implantation difficulty by affecting the blood flow to the uterine cavity
- By affecting the uterine lining
Submucosal and intermural fibroids and fertility
Of all the cases of fibroids, the most likely to affect fertility is the case of sub-mucosal fibroids.
Ongoing pregnancy, pregnancy rates, live birth rates, and implantation rates are low in women with submucosal fibroids.
Further, this type of fibroid is also associated with an increased risk of abortions.
As per an old study on the outcome of Assisted Reproductive Technology (ART), the following were the results of pregnancy rates per transfer:
| Types of Fibroids | Pregnancy rates per transfer | Implantation rates |
|---|---|---|
| Subserosal fibroids | 34.1% | 15.1% |
| Intramural fibroids | 16.4% | 6.4% |
| Submucosal fibroids | 10% | 4.3% |
| No fibroids | 30.1% | 15.7% |
Further, as per the study, it was found that pregnancy and implantation rates were comparatively lower in women with intramural fibroids and submucosal fibroids, even if there were no uterine deformations.
Also Read: To learn more about fibroids’ effect on pregnancy, read “Pregnancy With Fibroids-Can Fibroids Cause Miscarriage.”
Diagnosis of fibroids and infertility
Women with fibroids can consult a healthcare practitioner and take the following diagnostic tests:
- Ultrasound: Ultrasound uses sound waves to get an image of a woman’s uterus and detect the presence of fibroids
- Magnetic Resonance Imaging (MRI): This test can show the more detailed view of a woman’s uterus and about the size and location of fibroids
- Hysteroscopy: In this exam, a healthcare practitioner inserts a small hysteroscope (telescope) in the uterus. Then saline is injected to detect fibroids
How to improve fertility with fibroids
The treatment for fibroids fertility is as follows:
| Characteristics | Treatment |
|---|---|
| Asymptomatic women with fibroids | Clinical surveillance |
| Infertile women with distorted uterine cavity | Myomectomy, such as in submucosal fibroids |
| Symptomatic women who wish to get pregnant in the future | Myomectomy or medical treatment |
| Symptomatic women who wish to preserve their uterus | Myomectomy, medical treatment, Uterine Artery Embolization, magnetic resonance-guided focused ultrasound surgery |
| Symptomatic women who do not desire future pregnancy | Hysterectomy for fibroids with the least invasive approach |
Does removing fibroids improve fertility
The answer to whether removing fibroids improves fertility can vary from person to person, depending on the type of fibroids.
For example, fibroids in the subserosa (fibroids developed outside the uterus wall) are highly unlikely to threaten fertility.
Furthermore, women with more than six fibroids removed were less likely to get pregnant and need fertility treatment than women with less than six fibroids.
It can happen due to the amount of blood loss during the removal of fibroids greater than six, which increases the complications of myomectomy outweigh its benefits.
In the case of submucosal fibroids, the clinical pregnancy rates were higher after the myomectomy.
However, the ongoing pregnancy and live birth rates were still below the statistical significance.
Therefore, it is recommended to consult a healthcare practitioner and seek early diagnosis and treatment for faster recovery.
Conclusion
Fibroids can affect a woman’s fertility and may increase the risks leading to infertility.
It can block the fallopian tube, impair gamete transport, and alter the uterus.
Further, fibroids can change the cervix shape and movement of sperm and cause implantation difficulty.
Further, pregnancy and implantation rates are lower in women with intramural and submucosal fibroids compared to women without them.
A woman with fertility issues or fibroids must consult a healthcare practitioner and seek a proper diagnosis, including ultrasound, laparoscopy, and hysteroscopy.
Furthermore, depending on the characteristics of fibroids in women, a doctor will employ the treatment option.
Frequently Asked Questions
What are the effects of uterine fibroids on fertility?
Fibroids can block the fallopian tubes and impair gamete transport. Further, it can change the uterus shape and affect the movement of sperm or embryos. Also, it changes the shape of the cervix. It causes implantation difficulty by affecting the blood flow to the uterine cavity.
Can fibroids affect your fertility?
Yes, fibroids can affect a woman’s fertility. As per a 2021 report, fibroids are one of the causes of 2-3% of women. Furthermore, the size and location of fibroids can significantly affect fertility. For example, submucosal or fibroids greater than 6 cm in diameter can cause infertility.
Do fibroids reduce fertility?
Yes, submucosal and intramural fibroids can lead to fertility problems. These fibroids can block the fallopian tube and impair gamete transfer. Furthermore, fibroids can alter the shape of the cervix or uterus and can also make implantation difficult. Women should consult a healthcare practitioner and seek prompt medical treatment.
What size of fibroids can cause infertility?
The submucosal fibroids or fibroids greater than 6 cm in diameter can cause infertility. You should consult a healthcare practitioner and seek prompt medical treatment to improve your chances of getting pregnant.
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