Can Fibroids Affects Your Fertility?

Posted By Dr. Deepti Asthana on 27-02-2020

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Fibroids are also called leiomyomas and myomas. They are noncancerous benign tumors made up of smooth muscle cells and fibrous connective tissue. They grow in the woman's womb when they are in their childbearing years. Girls or women have generally more than one fibroid. The fibroid can vary in size.

It can range from the size of a bean to as large as a melon. Fibroids also vary in the location in the body. They can modify the size and location of the uterus. They can also affect the cervix. The size and location are often the reason whether the person experience symptoms or experience infertility and necessitate treatment.

There are three different types of fibroids. They differ based on where they are located in the body. The types include:

• Subserosal: They occur in the outer wall of the uterus.
• Intramural: They are present in the muscular layers of the uterine wall.
• Submucosal: It is found in the uterine cavity.

Can Fibroids Cause Infertility?

There are so many factors that play a part in affecting the ability of a woman to get pregnant and deliver a baby. One of the factors that affect about 25 to 50% of women is uterine fibroids. It is a common medical condition. If a mother has fibroids, there is a big possibility that her daughter might have them as well.

Whether fibroids cause infertility or not has been a complex issue. According to studies, about 5 - 10% of girls or women having infertility have fibroids in the body. It is usually the size and the location of the fibroids that cause the problems. There are cases when fibroids can affect the ability to get pregnant and deliver a baby. This is caused when the fibroids are very large- larger than 6 cm in diameter and are located inside the uterine cavity.

Research also suggests that it is only submucosal fibroids which protrude into the uterus can affect fertility in women. Women having fibroids is not criteria for facing infertility. But if the problem persists, a woman should consult her partner and find out if the other factors are responsible before proceeding for the treatment of fibroids.

A fertility specialist can be of great help in analyzing whether fibroids are an issue for you or not. He/she can also tell whether any treatment is necessary or not. Uterine fibroids do affect your fertility in many different ways. But it depends on how the fibroids' size and location modify the uterus, cervix or fallopian tubes. Some ways on how the fibroids can cause infertility are as under:

• Fibroids can change the thickness of the uterine lining.
• Any impact in the shape of the uterus can interfere with the movement of the embryo or the sperm.
• The flow of blood in the uterine cavity may also be affected. This decreases the ability of an embryo to develop.
• Fibroids can block the fallopian tubes making a fertilized egg to implant difficult or impossible.
• A change in the shape of the cervix can affect the sperms count that can enter the uterus.

What are the Symptoms and the Treatment of the fibroids?

Fibroids are non-cancerous tumors. They originate from the muscle layers of the womb. They generally develop in women who are in the age group between 15 to 50 years of age. These are the reproductive years during which estrogen levels are very high. According to studies, on average every third woman in the world experiences the fibroid formation in their body. They experience the following symptoms:

• Lower abdomen discomfort (especially when there are large fibroids)
• Labor problems
• Dyspareunia or pain during intercourse
• Pregnancy-related problems like bleeding, pain
• Fertility problems
• Menorrhagia or heavy and painful periods
• Anemia from heavy periods
• Lower backache or pain in legs
• Constipation
• Frequent urination
• Repeated miscarriages
• Weight gain and swelling in the lower abdomen

Fibroids usually need no treatment. The treatment should depend on your situation. The treatment should also depend on whether there are any other reasons for infertility. The treatment is only advised if the symptoms are severe. At first place, the doctor will recommend the treatment through medication. Medications may include the following:

• GnRH drug
• Nonsteroidal anti-inflammatory drugs
• Birth control pills
• Levonorgestrel intrauterine system (LNG IUS)

Surgery for the treatment of fibroids is recommended only in cases where severe fibroids do not respond to more conservative treatment options like medications, etc. Depending on the severity, different procedures may be adopted. The procedures include:

• Hysterectomy: This procedure will result in partial or total womb removal in case of very large fibroids or excessive bleeding. If a doctor removes ovaries and fallopian tubes, side effects may include reduced libido and early menopause.
• Myomectomy: It involves the removal of fibroids from the muscular wall of the womb. This type of surgery is not beneficial and recommended in case a woman has large fibroids. It is also not beneficial if the fibroids are located in particular parts of the womb.
• Endometrial Ablation: It is a procedure that involves the removal of the lining inside the womb and may help if fibroids are near the inner surface of the womb.
• Uterine Fibroid Embolization: In this fibroids are made small with the help of fluoroscopic X-ray imaging, a chemical is injected through a catheter to cut off blood supply into the arteries. This shrinks the fibroids.
• MRI-Guided Focused Ultrasound Surgery: This method is also done to shrink the fibroids.

An MRI scans and locates the fibroids in the body. High energy ultrasound waves are then delivered to shrink them.

• MRI-Guided Percutaneous Laser Ablation: Using an MRI scan, fibroids are located and they are made to shrink. The laser fiber devices are inserted through the skin to reach the fibroids in the body. The laser light then shrinks the fibroids.

Author: Dr. Deepti Asthana has been associated with Fortis Memorial research institute Gurgaon for the past four years and is working as a consultant there at present.