Fibroids and Infertility

While uterine fibroids can cause a variety of symptoms, they may not cause any symptoms at all. Some women may not even know that they have one. When a woman has fibroids pressing on the uterus, it can prevent normal attachment of a fertilized egg to the inner lining of the uterus. Or, if a embryo does attach to the uterus, the fibroid can limit the embryo's growth and cause loss of the pregnancy. Both of these effects from fibroids lead to infertility.

Uterine fibroids are common, and they are found in up to 75% of the general female population, and 5-10% of infertile women. Certain types of fibroids are known to decrease fertility more than others. The most common fibroid to cause infertility are the ones that are inside the uterine cavity. The other type of fibroids that can cause infertility are very large fibroids (>6 cm in diameter) that are located within the wall of the uterus. Because most women with fibroids will have normal fertility, they should have a thorough evaluation by a fertilty doctor to detect other problems that can decrease fertility. That fertility specialist can help determine if fibroids might be hampering their ability to conceive.

Watch Dr. Mark Kan Discuss Fertility and Fibroids

Dr. Mark Kan, the Medical Director of Newport Fertility, discusses how fibroids can affect fertility as well as treatment options.

How do fibroids cause infertility?

There are several explanations for why uterine fibroids may reduce fertility.

  • Changes in the position of the cervix (the vaginal opening to the womb) due to fibroids located above it may affect the number of sperm that can travel through the cervix.
  • Changes in the shape of the uterus can interfere with sperm movement.
  • Blockage of the fallopian tubes by the fibroids.
  • Affecting the blood flow to the uterine cavity where the embryo would implant.
  • Changes in the uterine muscle that prevents movement of the sperm or the embryo.

What happens to fibroids during pregnancy?

Fibroids are found in 2% to 12% of pregnant women. Not all fibroids will increase in size and complicate a pregnancy. If a fibroid grows, it will typically do so in the first 12 weeks of pregnancy and sometimes shrink as the pregnancy continues.

What can happen if a fibroid does grow during pregnancy?

In some instances, fibroids can possibly outgrow their blood supply and cause severe pain that might lead to hospitalization. Also, fibroids can change the baby’s presentation (position at birth), increase the risk of a cesarean section, miscarriage and preterm delivery. The management of uterine fibroids depends on your doctor’s recommendations. Rarely is surgery necessary or performed during pregnancy.

Summary of Fibroids and Fertility

Uterine fibroids are common and can affect fertility in many ways. They can affect ovulation, fertilization and implantation. Treatment options vary, but treatment will help to address the gynecologic symptoms of fibroids and improve overall fertility. The management of uterine fibroids will depend upon the severity of your symptoms and your doctor’s recommendations.

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