Uterine fibroids can often – embarrassingly – make you look and feel like you’re pregnant. The bloated stomach, the need to go to the bathroom every five minutes, the constipation… ugh.
But if you want to be pregnant – really pregnant – your fibroids might give you cause for concern:
- Can they prevent you from getting pregnant?
- Can they interfere with your ability to carry a healthy baby to term?
- Can fibroid treatments you’ve undergone or are thinking about undergoing damage your fertility?
They’re uncomfortable, troubling questions for a woman who desires a family. Let’s answer them.
Fibroids Don’t Usually Affect Fertility
That’s the good news. Fibroids – disruptive though they may be to you – can usually get along with your unborn baby just fine. Consider that 20-50% of women experience uterine fibroids at some point in their lives, and many of those women end up bearing children, with or without awareness of their fibroids.
The National Institutes of Medicine say that fibroids “are estimated to have a detrimental effect on fertility in up to 10% of cases. They are also associated with an increased risk of miscarriage in women who conceive and half the live birth rate in in vitro fertilization cycles.”
Yet in a major review study of over 100 papers, the impact of uterine fibroids on fertility was found to be questionable. Only 1% to 2.4% of infertile women had fibroids and no other apparent cause for infertility. One assessment of pregnancy rates for infertile women after their fibroids were removed via myomectomy indicated that the removal was beneficial to their ability to conceive. Comprehensive studies comparing placement and size of fibroids and their impact on fertility have not yet been done, although one other study indicated that submucosal fibroids (hanging or projecting into the uterus) were the only ones to noticeably impact fertility rates.
If you have uterine fibroids and want to conceive, your fibroids should not be a concern for you. If you have fibroids and are experiencing infertility, however, fibroid removal may be something to try if there is no other apparent cause and other fertility treatments have been successful.
Fibroid Treatments and Fertility
Though fibroids themselves have a debatable impact on fertility and healthy pregnancy, fibroid treatments are less up for debate. The range of available treatments has expanded greatly in the past twenty years, which is wonderful for fibroid sufferers. If you’re hoping to conceive, you should be aware of the potential impact of fibroid treatments on your ability to have a healthy pregnancy.
Myolysis (using focused energy to destroy the fibroids)
Pregnancy is not recommended after myolysis because of the risk of adhesion formation and rupture.
Uterine artery embolization (blocking the arteries supplying the fibroid so they shrink and die)
Pregnancy is not recommended after uterine artery embolization. Pregnancy may be successful, but in the few studies performed so far, there has been a higher risk of complications, particularly relating to the placenta.
Myomectomy (surgical removal of fibroids)
Pregnancy is possible and often successful after myomectomy. Women who have undergone myomectomy in an attempt to treat unexplained infertility have a spontaneous conception rate of 60%. Scarring may on occasion impact fertility. The method of myomectomy may make a difference, with chance of rupture during labor potentially increasing after laparoscopic myomectomy.
Hysterectomy (surgical removal of the uterus)
This is the end-of-the-line treatment for uterine fibroids. With no uterus, all uterine fibroid-related issues will cease, but so will your ability to bear children.
Fibroids and Your Future Family
Many women with uterine fibroids successfully conceive and bear children. If you are experiencing issues conceiving, and you suspect that fibroids may be a contributing factor, especially if there is no other obvious infertility cause, see your doctor. With thought and planning, you can increase your chances of having the family you want
