Fibroids are common — up to 80% of women develop them by age 50. Most cause no symptoms and don’t interfere with getting pregnant. But for some women, fibroids are obstacles to conception or carrying a pregnancy to term.
At Solace Women’s Care in Conroe, Texas, Farly Sejour, MD, FACOG, and Natalie Gould, WHNP-BC, along with our team, help women understand when fibroids may be affecting their fertility and what treatment options can improve their chances of conceiving.
Fibroids are noncancerous growths that develop in or around your uterus. They range from tiny seedlings to masses large enough to distort your uterus. Size doesn’t always predict fertility problems; where the fibroid grows determines how much it interferes with conception and pregnancy. There are several different types, such as:
These fibroids grow into the uterine cavity, distorting the space where an embryo needs to implant. Even small submucosal fibroids can prevent implantation or increase miscarriage risk because they take up room that should be available for a developing pregnancy.
They also increase bleeding during periods and between cycles, creating an inflammatory environment that makes implantation harder.
Intramural fibroids grow within the muscular wall of your uterus. Large ones can distort the uterine cavity or block the fallopian tubes where they enter the uterus. Smaller intramural fibroids that don’t change the cavity shape typically don’t affect fertility.
These grow on the outer surface of your uterus and don’t usually interfere with conception unless they become large enough to block the fallopian tubes or create pressure on surrounding organs.
When fibroids do affect fertility, they can physically block sperm from reaching an egg by distorting the cervix or blocking the fallopian tube openings. They prevent a fertilized embryo from implanting properly by taking up space in the uterine cavity or altering the uterine lining.
Some fibroids disrupt blood flow to the uterine lining or trigger chronic inflammation that makes the uterus less receptive to pregnancy.
Many women discover they have fibroids during routine pelvic exams or ultrasounds. If you’re planning to get pregnant and have known fibroids, we evaluate their size, number, and location to determine if they might cause problems.
A transvaginal ultrasound helps identify the location of fibroids and their relationship to the uterine cavity. For a more detailed view, especially of submucosal fibroids, we might use saline infusion sonography or hysteroscopy.
These tests help us predict which fibroids are likely to cause fertility problems and which ones you can safely leave alone.
Not every fibroid needs treatment before you try to conceive. Small fibroids that aren’t distorting the uterine cavity usually don’t require intervention. When fibroids are likely to interfere with pregnancy, myomectomy surgically removes them while leaving your uterus intact.
The approach depends on the location of the fibroid. Hysteroscopic myomectomy removes submucosal fibroids through the cervix without any incisions, while laparoscopic or open surgery accesses fibroids in the uterine wall or on the outer surface. We typically recommend waiting at least three months after myomectomy before trying to conceive to allow complete healing.
If you’re planning in vitro fertilization (IVF), we likely recommend removing submucosal fibroids first because they can reduce success rates.
Fibroids don’t automatically mean you’ll have trouble getting pregnant, but understanding their effect on your fertility helps you make informed decisions about treatment before trying to conceive.
Call our Conroe office at 936-441-7100 or message us online to schedule a consultation with our team today.
