Fibroids and Fertility: Causes, symptoms, treatments, and impact on pregnancy

Fibroids are a common concern for many people, particularly women who are considering starting a family. These non-cancerous growths in the womb can cause a range of symptoms, most commonly heavy periods, but they can range from mild discomfort to significant pain and complications. At Care Fertility, we provide clear, compassionate information to help you understand fibroids, their impact on your fertility, and the treatments available to you.

What are fibroids? 
Fibroids, also known as uterine fibroids or myomas, are benign tumours that develop in the muscular wall of the uterus. They vary in size, from as small as a seed to as large as a grapefruit. While they are typically non-cancerous and often don’t cause any symptoms, in some cases, they can cause considerable discomfort and affect a person's quality of life.  

Studies show that fibroids affect approximately 35-77% of reproductive-age women, and nearing age 50, this likelihood may increase to 70-80% depending on the patient's ethnicity. They are the most common tumour in women and are highly prevalent in patients with infertility. Fibroids are present in 5-10% of infertile patients and may be the sole cause of infertility in 1-2.4% of cases.¹ 

Types of fibroids 

There are different types of fibroids, classified based on their location in the uterus: 

Intramural Fibroids: These develop in the womb muscle and may distort the shape of the uterus if they grow big enough, sometimes causing heavy periods, pressure, and pain. 

Subserosal Fibroids: This type of fibroid begins in the muscle wall but later protrudes into the pelvis. 

Submucosal Fibroids: These fibroids grow into the uterine cavity and often cause fertility problems. 

Causes and risk factors 
The exact cause of fibroids is not well understood, but several factors may contribute to their development: 

Hormonal changes: Oestrogen and progesterone, hormones that regulate the menstrual cycle, can promote the growth of fibroids. 

Genetics: A family history of fibroids increases the likelihood of developing them. 

Age: Fibroids are most common in people aged 30-40. 

Lifestyle factors: Diet, obesity, and high blood pressure are associated with an increased risk of fibroids. 

Symptoms of fibroids 
Symptoms vary depending on the size, number, and location of the fibroids. Common symptoms include: 

• Heavy or prolonged menstrual periods 
• Pelvic pain or pressure 
• Going to the toilet frequently 
• Difficulty emptying the bladder 
• Constipation 
• Backache or leg pains 

Unfortunately, in some cases, fibroids can lead to reproductive issues, including infertility, miscarriage, and complications during pregnancy and labour. 

How fibroids affect fertility 
While many people with fibroids conceive without difficulty, fibroids can impact fertility in several ways: 

Fallopian tube blockage: Fibroids can block the fallopian tubes, preventing sperm from reaching the egg. 

Uterine cavity distortion: Fibroids that grow inside the uterine cavity can distort its shape, making it difficult for an embryo to implant. 

Blood flow interference: Fibroids can interfere with the blood flow to the uterine lining, affecting embryo implantation and growth. 

Cervical changes: Fibroids located near the cervix can change its shape, which might reduce the number of sperm entering the uterus. 

Diagnosing fibroids 
If you're experiencing symptoms or having trouble conceiving, your doctor might suggest a few diagnostic tests to check for fibroids. These can include: 

Ultrasound: A common imaging test to visualise the uterus and detect fibroids. 

MRI: Provides detailed images of fibroids and helps in planning treatment. 

Hysteroscopy: Involves inserting a small camera into the uterus to inspect for fibroids and other abnormalities. 

Treatment options 
There are a range of treatment options available for fibroids, ranging from medication to surgery. The best approach depends on the severity of the symptoms, the size and location of the fibroids, and your reproductive goals. 

 
Medications: Hormonal treatments can help regulate your menstrual cycle, reduce symptoms, and shrink fibroids – however, they are generally contraceptives and not recommended for women trying to get pregnant.  

Minimally invasive procedures: Options such as laparoscopic myomectomy uterine artery embolisation (UAE) can remove or shrink fibroids with less recovery time than traditional surgery. UAE isn’t recommended for women who have not yet completed their family.  

Surgical options: In severe cases, a myomectomy (removal of fibroids), may be recommended for women who are trying to get pregnant. As a last resort, a hysterectomy (removal of the uterus) may be necessary.  

Fertility treatment with fibroids 
If you have fibroids and are trying to conceive, working with a fertility specialist is crucial. Here at Care Fertility, we offer personalised treatment plans tailored to your unique needs. There are a range of treatment options available to you if you have fibroids that are affecting your fertility, these include: 

Intrauterine Insemination (IUI): A procedure that places sperm directly into the uterus, increasing the chances of conception. 

In Vitro Fertilisation (IVF): A process where eggs are fertilised outside the body and then implanted into the uterus. IVF can be particularly beneficial if fibroids are affecting your fallopian tubes or uterine cavity. 

Pre-treatment with medication: Sometimes, hormonal treatments are used before fertility treatments to shrink fibroids and improve outcomes. 

Emotional and psychological support 
Dealing with fibroids and fertility challenges can be emotionally taxing. At Care Fertility, we provide comprehensive support, including counselling and support groups, to help you navigate this journey with confidence and peace of mind. 

Starting your family with Care Fertility 
Fibroids can pose challenges to fertility, but with the right diagnosis and treatment, many people successfully conceive and have healthy pregnancies. At Care Fertility, we are dedicated to providing you with the best care and support. If you have concerns about fibroids and fertility, don’t hesitate to reach out to us. We’re here to listen, support, and help you every step of the way. 

Ready to take the next step? Contact Care Fertility today to schedule a consultation with one of our specialists. We’re here to help you understand your options and achieve your dream of building a family. 

¹ Guo, X. C., & Segars, J. H. (2012). The impact and management of fibroids for fertility: An evidence-based approach. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608270/