Among many medical conditions that can potentially affect a woman’s fertility, fibroid is the most common. Fibroids are benign (noncancerous) tumours growing inside or on the woman’s uterus or womb. The relationship between fibroid and fertility can be unpredictable as the former might or might not impact a woman’s fertility and pregnancy chances. 

Approximately 20% to 80% of women are found to develop these noncancerous tumours by the age of 50, with 30% of women aged between 25 and 44 having fibroid symptoms. These figures indicate that females are more likely to have uterine fibroids during their childbearing years.

So, can fibroid impact a woman’s fertility and pregnancy chances and if yes, how? Read on to know the answers and explore the symptoms, causes, and treatment of fibroids.

What are Fibroids?

Fibroids or uterine fibroids are noncancerous tumours of muscle tissue inside or on a female’s uterus or womb. They are also referred to as myomas or leiomyomas. 

Are you wondering how these fibroids occur? Well, they occur when a single cell in your uterus’ wall multiplies and grows to develop a benign tumour. Moreover, these noncancerous tumours can change your womb’s shape or size and sometimes can also impact the cervix (lower part of your uterus). 

Fibroids can be classified into three main types, depending on where they are formed:

• Intramural fibroids are formed in the muscular layers of your uterine wall
• Subserosal fibroids are found in your uterus’ outer wall
• Submucosal fibroids protrude into the uterine cavity.

Can Fibroids Decrease Woman’s Fertility?

Fibroids can go undetected in many healthy women. Depending on their size or location, they may affect a person's ability to get pregnant or stay pregnant or have a healthy pregnancy. The fertility of many women isn't affected by fibroids, and thus, they can get pregnant naturally without needing the conception treatment. However, in some cases, these noncancerous tumours can negatively affect your fertility. For instance, submucosal fibroids form and bulge into your uterine cavity and can more likely make you infertile or increase the risk of pregnancy loss.

It's found that about 5% to 10% of infertile females are diagnosed with fibroids.

How Can Fibroids Cause Infertility?

The following are some ways how fibroids can reduce a woman’s fertility:

• Fibroid can change the shape of the cervix, affecting the number of sperm that can enter a woman’s uterus.
• Fibroids can block your fallopian tubes.
• Fibroids can impact the size and shape of the lining of your uterine cavity.
• They could affect blood flow to the uterine cavity, decreasing the embryo’s ability to stick to the uterine wall or develop.

Can Fibroids Affect Pregnancy?

Usually, most women don’t experience any effects due to fibroids during their pregnancy. However, a 2010 review discovered that 10% to 30% of women with noncancerous tumours in or on their uterus can develop complications during pregnancy. 

The most common complication that pregnant women with fibroids larger than 5 cm develop when having fibroids is pain. Below given are some other complications fibroids can cause during pregnancy and delivery:

• Miscarriage- the risk of miscarriage is higher for people with fibroids than those without.
• Placental abruption- the placenta separates from the uterine wall, which can reduce the amount of oxygen and nutrients reaching the fetus. This can increase the risk of miscarriage or preterm birth.
• Preterm labour- the baby is born before the 37th week of pregnancy.
• Fetal growth restriction- the baby doesnot grow as well as expected.
• Caesarean section- there is increased chances of caesarean section.
• Abdominal pain- may experience pain in pregnancy due to red degeneration.
• Frequent urination- a large fibroid can put pressure on the bladder, increasing the urge to urinate.

Knowing the Risk Factors for Developing Fibroids

Here outlined are the risk factors or causes of fibroid:

• Age (older women are at higher risk than younger women)
• African American race
• Obesity
• Family history of uterine fibroids
• High blood pressure
• Vitamin D deficiency
• Food additive consumption

Signs and Symptoms of Fibroids 

The size and number of fibroids present in your uterus can determine the fibroid symptoms you will be experiencing. The signs of fibroids are missing in some women, while others might experience:

• Lower back pain
• Enlargement or a feeling of fullness in their lower abdomen
• Heavy bleeding and pain during periods
• Pain during sex
• Frequent urination

How to Treat Fibroids to Improve Fertility?

Fibroids can be cured using various approaches based on size, symptoms, and patient preferences. Here are some effective fibroid treatment options:

Medication:

• Hormonal Therapy: Medications like Gonadotropin-Releasing Hormone (GnRH) agonists can reduce estrogen and progesterone levels, shrinking uterine fibroids. Undergoing hormonal therapy might be useful before surgery to remove fibroids.
• Birth Control Pills: Having low doses of birth control pills, IUDs, or progesterone-containing birth control injections can help prevent fibroids from growing and control heavy menstrual bleeding.
• Anti-inflammatory Drugs: If your symptoms are mind, taking NSAIDs like ibuprofen can relieve pain associated with fibroids, especially during periods.

Surgical Procedures:

• Laparoscopic or Robotic Myomectomy: This medical procedure is all about removing fibroids through small abdominal incisions and preserving the uterus for potential future pregnancies.
• Hysteroscopic Myomectomy: It’s suitable for fibroids within the uterine cavity as hysteroscopic myomectomy removes the noncancerous tumours through the vagina and cervix.
• Uterine Artery Embolization (UAE): It involves blocking the blood supply to fibroids to cause them to shrink by injecting blocking particles into the patient’s blood vessels.
• Hysterectomy: The entire uterus is removed via hysterectomy for a definitive solution for fibroids. It’s typically recommended for women with severe symptoms or when fertility preservation is not a concern.
• MRI-Guided Focused Ultrasound Surgery (FUS): This surgical procedure uses high-intensity ultrasound waves to heat and destroy fibroid tissue.

Lifestyle and Home Remedies:

• Dietary Adjustments: You shouldn’t consume red meat and instead have a diet rich in fruits, vegetables, and whole grains to manage fibroid symptoms.
• Regular Exercise: Since obesity is one of the causes of fibroids, maintaining a healthy weight can help reduce symptoms.

All-in-All

Treating fibroids on time can help increase your fertility chances. Have questions and concerns about fibroids? Discuss them with obstectics and Gynaecology specialists at Medanta to find the best course of treatment to manage your fibroid symptoms and increase your chance of conceiving.