Uterine Fibroids and Fertility: When Do They Affect Your Chances of Pregnancy?

So, one person comes in, sits down and makes his place and then doesn't go away, without taking his snacks with him! The good news? Doctors point out that most women with fibroids will have a healthy pregnancy, but at times the fibroid can be an issue, and at times it's just a nice thing to have along for the ride.

If you have been told you have uterine fibroids and are trying for a baby, it is perfectly OK to be worried. Questions such as "Will I be able to get pregnant?" or "Does surgery need to be done prior to IVF?" are frequently asked, and the answer depends on the fibroid type, size, and location.

Fortunately, fibroids do not always affect fertility. Many women with fibroids conceive naturally and go on to have healthy pregnancies. In some cases, however, fibroids can make pregnancy more difficult by interfering with conception or implantation, making an early fertility evaluation important.

The World Health Organization (WHO) estimates that up to 70% of women will develop uterine fibroids by the age of 50, although many never experience symptoms. Understanding whether fibroids are affecting fertility helps determine whether treatment is necessary.

Let's explore how fibroids influence fertility, when treatment may be recommended, and how IVF can help in certain situations.

What is a Uterine Fibroid?

Uterine fibroids, also called leiomyomas or myomas, are non-cancerous growths that develop within the muscular wall of the uterus, the organ where a baby grows during pregnancy.

Fibroids vary greatly in size. Some remain very small and cause no symptoms, while others can become large enough to change the shape of the uterus.

They are common during the reproductive years and are influenced by the hormones estrogen and progesterone. Importantly, uterine fibroids are almost always benign and very rarely become cancerous.

What Are the Symptoms of Uterine Fibroids?

Symptoms vary from woman to woman. Some women never experience symptoms and only discover fibroids during a routine examination or fertility assessment.

If symptoms occur, they may include:

• Heavy or prolonged menstrual periods
• Painful menstrual cramps
• Pelvic pain or pressure
• Frequent urination
• Constipation
• Pain during sexual intercourse
• Lower back pain
• Difficulty becoming pregnant in some cases

The impact of fibroids depends not only on their number but also on their size and location.

Do Fibroids Always Affect Fertility?

No. This is one of the biggest misconceptions about uterine fibroids.

Many specialists agree that small fibroids located within the muscular wall of the uterus or on its outer surface often do not affect fertility.

The concern arises when fibroids change the shape of the uterine cavity, interfere with embryo implantation, block the fallopian tubes, or affect normal uterine function. For this reason, fertility specialists evaluate the size, location, and symptoms before recommending treatment.

Which Types of Fibroids Can Affect Pregnancy?

Submucosal Fibroids

Submucosal fibroids develop inside the uterine cavity, where an embryo normally implants.

These fibroids are most strongly associated with reduced fertility, implantation failure, and miscarriage. They often require treatment before fertility procedures.

Intramural Fibroids

Intramural fibroids develop within the muscular wall of the uterus.

Small intramural fibroids may have little or no impact on fertility. However, larger fibroids, especially those that distort the uterine cavity, may reduce implantation rates and lower IVF success.

Subserosal Fibroids

Subserosal fibroids grow on the outer surface of the uterus.

These fibroids usually do not affect fertility unless they become very large or press against nearby organs.

How Do Fibroids Affect Fertility?

Fibroids may affect fertility in several ways depending on their size and location.

• They can change the shape of the uterine cavity, making embryo implantation more difficult.
• They may block the fallopian tubes, preventing sperm and egg from meeting naturally.
• Large fibroids can reduce blood flow to the uterine lining, making implantation more difficult.
• Some fibroids may increase the risk of miscarriage or pregnancy complications.

Despite these possibilities, many women with fibroids experience no fertility problems at all.

How Are Uterine Fibroids Diagnosed?

If fibroids are suspected during a fertility evaluation, your doctor may recommend imaging tests to determine their size, number, and location.

Common diagnostic tests include:

• Pelvic ultrasound
• Transvaginal ultrasound
• Saline infusion sonography (SIS)
• Positron Emission Tomography (PET) in selected cases
• Hysteroscopy to examine the inside of the uterus when necessary

These investigations help determine whether fibroids are likely to interfere with fertility or pregnancy.

Do Fibroids Need to Be Removed Before IVF?

Not always. Whether surgery is recommended depends on several factors.

• Size of the fibroids
• Location of the fibroids
• Whether they distort the uterine cavity
• History of previous miscarriages
• Previous IVF outcomes
• Symptoms such as heavy bleeding or pelvic pain

Fibroids that grow within the uterine cavity often reduce IVF success and are commonly treated before beginning IVF.

Small fibroids located on the outer surface of the uterus frequently do not require removal before treatment.

The decision should always be individualised to balance the benefits of surgery with the goal of achieving the highest possible pregnancy success.

Can You Have a Healthy Pregnancy with Fibroids?

Yes. Most women with fibroids have healthy pregnancies and deliver healthy babies naturally or with fertility treatment.

However, large fibroids or fibroids in certain locations may require closer monitoring because they can occasionally cause pain, preterm labour, or changes in the baby's position during pregnancy.

Regular prenatal care allows your healthcare provider to monitor both the pregnancy and the fibroids throughout each stage.

Personalised Fertility Care for Women with Fibroids at MMCIVF

MMCIVF provides personalised fertility care for women with uterine fibroids who are trying to conceive.

Every patient's fertility journey begins with a detailed assessment using advanced imaging and fertility testing to determine whether fibroids are affecting natural conception or IVF success.

Treatment plans are customised based on:

• Type of fibroid
• Size of the fibroid
• Location of the fibroid
• Patient's age
• Medical history
• Overall fertility status

MMCIVF combines modern reproductive technologies, evidence-based fertility treatments, and personalised care to maximise pregnancy success while avoiding unnecessary procedures whenever possible.

Conclusion

Uterine fibroids are extremely common, and in most cases they do not prevent pregnancy. The most important question is whether the fibroids are affecting fertility based on their size, location, and impact on the uterus.

If you are planning pregnancy or IVF, a comprehensive fertility evaluation can help determine the best course of action. With appropriate care, modern fertility treatments, and personalised management, many women with fibroids successfully achieve healthy pregnancies.

Frequently Asked Questions (FAQs)

1. Can I get pregnant naturally if I have fibroids?

Yes. Many women with fibroids conceive naturally without fertility treatment. Whether fibroids affect fertility depends primarily on their size and location.

2. Should all fibroids be removed before IVF?

No. Only fibroids that distort the uterine cavity or interfere with embryo implantation are usually treated before IVF.

3. Can fibroids increase the risk of miscarriage?

Yes. Certain fibroids, particularly submucosal fibroids, may increase the risk of miscarriage by altering the shape of the uterine cavity or interfering with embryo implantation.

4. Can fertility treatment still be successful if fibroids are present?

Yes. Fertility specialists use detailed imaging to assess the number, size, and location of fibroids before creating an individualised treatment plan that offers the best chance of pregnancy.