According to the American Society for Reproductive Medicine (ASRM), fibroids are found in 20% of women of reproductive age. But do fibroids affect your fertility? For Fibroid Awareness Month this July, we are looking at how fibroids and infertility may be linked.
What are Fibroids?
Uterine fibroids are benign (noncancerous) tumors that grow in or on the uterus. Fibroids may also be referred to as myomas or leiomyomas. Most women who have fibroids have more than one at a time. There are three main types of fibroids (in order from most common to least common):
- Subserosal fibroids: Located on or in the outer wall of the uterus
- Intramural fibroids: Located in the muscular layers of the uterine wall
- Submucosal fibroids: Protrude into the uterine cavity
It is common for women to have fibroids and not have noticeable symptoms. However, some women with uterine fibroids experience the following symptoms:
- Painful periods
- Heavy bleeding during menstruation
- Bleeding between periods
- Lower back pain
- Frequent urination
- Pain during intercourse
- Infertility or recurrent pregnancy loss
Uterine Fibroids and Infertility
Just because a woman has fibroids does not mean that she will have fertility issues. According to the ASRM, only about 5% – 10% of women with infertility have fibroids and most women with fibroids will not be infertile. However, in some cases, fibroids can contribute to fertility problems depending on their size and location.
Uterine fibroids and infertility are linked in the following ways:
- Fibroids can block the fallopian tubes.
- Fibroids can change the shape of the cervix. This can decrease the number of sperm that make it to the uterus.
- The size or thickness of the uterine lining may be affected by fibroids.
- If fibroids change the shape of the uterus it can interfere with the movement of the sperm or an embryo.
Treating Fibroids for Fertility
If you’re experiencing difficulty with uterine fibroids and infertility, there are treatment options that may help. However, women who have fibroids should be evaluated by a fertility specialist for other causes of infertility before fibroids are treated. Her partner should also be evaluated.
In some cases, the symptoms caused by uterine fibroids can be managed with hormonal drug therapy. However, these hormonal medications are intended to stop ovulation and menstruation in order to reduce symptoms. Therefore, they are not an effective treatment for someone actively trying to get pregnant. However, gonadotropin-releasing hormone (GnRH) agonists may be prescribed for short-term use before a myomectomy to reduce bleeding.
Surgical Treatment for Fibroids
In cases where uterine fibroids are very large or are causing severe symptoms, a hysterectomy may be recommended. However, for women who wish to have children, there are other procedures that leave the uterus in place. These procedures include:
- Myomectomy: A myomectomy is the surgical removal of uterine fibroids while the uterus is left in place. This surgery can be done laparoscopically, with robot assistance, or in a traditional open procedure. If fibroids return, multiple surgeries may be required.
- Resection of submucosal myoma: A submucosal myoma is a fibroid located under the mucosal layer of the uterus that protrudes into the uterine cavity. Sometimes these fibroids can be removed with a procedure called a resection. This procedure can be performed with a hysteroscope. A hysteroscope is a long, thin telescope-like device that is inserted into the vagina into the uterus. This technique is less invasive than open procedures.
If someone is not a good candidate for drug therapy or surgery, there is another minimally invasive treatment available:
- Uterine fibroid embolization (UFE): Uterine fibroid embolization is a treatment option for women who are experiencing symptoms such as infertility due to fibroids. The procedure is minimally invasive and the woman keeps her uterus. During the procedure, a catheter is fed through an artery and guided to the fibroids. Tiny, round beads are injected into the blood vessels that feed the fibroids. This cuts off the blood supply to the fibroids and causes them to shrink.
Schedule a Consultation
The providers at Carolinas Fertility Institute have decades of expertise when it comes to fertility treatments. If you are struggling with fibroids and infertility, we can do a fertility evaluation. To achieve your dream of building a family, we encourage you to contact us today to schedule an initial consultation by calling our Charlotte office at (844) 686-2233 or our office in the Triad at (336) 448-9100.