Uterine Fibroids & Infertility – Can Fibroids Affect Fertility

What are Uterine Fibroids?

Also known as leiomyomas, uterine fibroids are non-cancerous growths that develop within or on the wall of the uterus. These benign growths are made up of smooth muscle cells and fibrous connective tissue. In terms of size, uterine fibroids can be as small as a pea or as large as a melon. It is also possible for a woman to develop more than one fibroid at the same time.

Uterine fibroids can be single or exist in clusters that can range from 1 millimetre to 20 centimetres or more. They are more commonly found in women aged 30 to 50. Those who have not had their first period or have reached menopause are not likely to develop the condition.

While any diagnosis of the reproductive system can cause worry, it is important to remember that uterine fibroids are not associated with an increased risk of uterine cancer. In fact, it is very rare for such growth to become malignant or cancerous over time.

Types of Fibroids and Their Locations

Not all fibroids have similar effects on the body. The effect of fibroids on fertility is significantly influenced by their location within or near the uterus. Four major types of fibroids include:

• Intramural fibroids: This is the most common form of fibroids. It occurs in the uterine muscle layer. It causes distortions to the uterine cavity when it is large.
• Submucosal fibroids: This kind grows under the lining of the uterus, the endometrium, and projects into the uterine cavity. This kind is the most associated with fertility issues.
• Subserosal fibroids: This kind grows from the surface of the uterus and extends outwards. Its effect on fertility is minimal unless it is large enough to affect the fallopian tubes.
• Pedunculated fibroids: These are attached to the uterus using a stalk. It may be subserosal or submucosal.

Symptoms That You Should Not Ignore

More often than not, uterine fibroids are asymptomatic. However, if a person does experience a few symptoms, they can have a considerable impact on daily life. Women should keep an eye out for the following warning signs:

• Bleeding during menstruation that can lead to anaemia
• Pelvic pain
• Frequent need to urinate and inability to fully void the bladder
• Pain during sexual intercourse
• Pain in the back or legs
• Feeling of abdominal bloating
• Difficulty conceiving and recurrent miscarriages

Can Fibroids Cause Infertility?

Conditions affecting the uterus will always pose the question: Will it impact fertility in women? In the case of uterine fibroids, it depends on a few factors. For starters, fibroids may not come in the way of pregnancy, but some could cause infertility or miscarriages, especially submucosal uterine fibroids.

Fibroids may affect fertility by:

• Blocking the fallopian tubes: Those uterine fibroids that are located close to the openings of the fallopian tubes can cause blockages or obstructions in the egg’s path, thus preventing fertilisation.
• Distorting the uterine cavity: Some fibroids, such as submucosal or large intramural fibroids, can distort the uterine cavity, making it almost impossible for the embryo to implant properly.
• Impact on blood flow: Blood flow to the endometrial tissue is necessary for sustaining an embryo growing within the body. When fibroids affect blood flow, the embryo will not get sufficient support.
• Stimulating inflammation: Uterine fibroids can trigger inflammation in the uterine lining, making it unsuitable for carrying a baby.

Studies show that uterine fibroids can contribute to infertility in 2-3% of women. Infertility and pregnancy loss caused by uterine fibroids mostly depend on their positioning in the uterus. In addition, it has been observed that fertility rates and live births are lower in women suffering from submucosal uterine fibroids.

How Fibroids Affect Pregnancy

• Miscarriage: Submucosal fibroids could cause miscarriages.
• Early labour: The occurrence of fibroids causes early labour contractions.
• Intrauterine growth retardation: The formation of large fibroids causes decreased space for foetal growth.
• Placental disorders: The development of fibroids adjacent to the placenta causes placental dysfunction.
• Malpresentation: The foetus will not be able to assume the right position due to the fibroid obstructing the bottom region of the uterus.
• Caesarean delivery: Caesarean delivery may be necessary due to the presence of fibroids.

Key Facts: Fibroids and Fertility

Conclusion

Uterine fibroids may be a common occurrence among women, but they are not always indicative of the cessation of fertility aspirations. Although some fibroids, especially submucosal, may hinder conception or pose threats during pregnancy, many women will still carry their babies to full-term with no problems at all. The secret here is recognising that the effect of fibroids on one’s reproductive capabilities largely depends on their size and position.

Should you be facing any issues or difficulties, seeking professional advice becomes crucial. With the current advances in diagnostic and treatment methods, such as myomectomy, it will become possible to treat your fibroids while preserving your ability to conceive.