The Impact of Uterine Fibroids on Fertility

As a fertility specialist, I’ve worked with many women whose hopes of becoming mothers were dimmed by the unexpected challenge of uterine fibroids. While fibroids are common—affecting up to 80% of women by the time they reach 50—they can still come as a shock when they’re linked to infertility. Fibroids are often found during routine pelvic exams or ultrasounds, and for many women, the news can feel overwhelming.

I remember one patient, Samantha, who came to see me after months of trying to get pregnant without success. At 34, she was healthy, active, and had no obvious reasons why she couldn’t conceive. Yet, after several months of negative pregnancy tests, she finally sought help. We ran a series of tests and discovered that she had multiple fibroids in her uterus. The largest one was sitting right at the entrance to her fallopian tubes. For Samantha, this was a turning point, one that would change the way we approached her fertility treatment.

Fibroids, while not always linked to infertility, can significantly impact a woman’s ability to conceive. And for those of us in the fertility world, it’s a condition that requires a careful, thoughtful approach to treatment.

What Are Uterine Fibroids?

Uterine fibroids are non-cancerous growths that develop in or on the uterus. They vary in size, and many women have no symptoms at all. Some women might experience heavy menstrual bleeding, pelvic pain, or frequent urination. But for others, the fibroids don’t cause noticeable symptoms—until infertility becomes an issue.

Fibroids can affect fertility in several ways:

• Blocking the fallopian tubes: Fibroids near the entrance of the tubes can prevent the egg from meeting sperm.
• Distorting the uterine cavity: Larger fibroids that alter the shape of the uterus can make it harder for a fertilized egg to implant.
• Disrupting blood flow: Fibroids can affect the blood supply to the uterus, making it less hospitable for a pregnancy.
• Interfering with sperm movement: Some fibroids can disrupt the normal flow of sperm into the uterus.

Samantha’s fibroid was particularly problematic because it was located at the entrance to her fallopian tubes, effectively blocking her eggs from reaching her uterus. This was preventing conception, despite her otherwise healthy reproductive system.

The Diagnosis and Journey Forward

When Samantha came to see me, she felt confused and a bit defeated. She had no idea that fibroids could be contributing to her fertility issues. “I thought I was healthy,” she said. “I had no idea that fibroids could affect my ability to get pregnant.”

It’s a common misconception. Many women are unaware that they have fibroids until they start trying to conceive. As Dr. Olivia Green, an expert in reproductive health, often says, “Fibroids can be the silent disruptors of fertility. Women may have them for years without knowing, and only when they face infertility do they realize the impact.”

Once we diagnosed Samantha with fibroids, we had to decide the best course of action. For women with fibroids who are trying to get pregnant, there are several potential options, depending on the size, location, and number of fibroids, as well as the woman’s overall fertility health.

How Fibroids Affect Fertility

Not all fibroids impact fertility, and in some cases, women with fibroids are able to conceive without any issue. However, in situations like Samantha’s, where the fibroids are blocking the fallopian tubes or changing the shape of the uterine cavity, fertility can be compromised.

• Submucosal Fibroids: These are fibroids that grow just beneath the lining of the uterus. They can distort the shape of the uterus, interfering with the implantation of a fertilized egg. These are the most likely to cause infertility.
• Intramural Fibroids: Located within the uterine wall, these fibroids may not directly affect fertility, but they can still change the shape of the uterus and impair its ability to carry a pregnancy to term.
• Subserosal Fibroids: These fibroids grow outside the uterus and generally don’t affect fertility directly, although they can cause complications during pregnancy, such as preterm labor.

Dr. Emily Hart, a renowned fertility expert, explains, “Fibroids are like roadblocks in the reproductive system. If the fibroids are in the way of the fallopian tubes or the uterus, it’s going to be difficult for a pregnancy to happen.”

Treatment Options for Fibroids and Fertility

The good news is that fibroids can be treated, and for many women, the right treatment leads to successful pregnancies. In Samantha’s case, we began by considering different approaches:

1. Medications to Shrink Fibroids
   In some cases, hormonal medications like GnRH agonists can be used to shrink fibroids temporarily, allowing the woman to conceive naturally. However, these medications are typically used as a short-term solution and are not recommended for long-term use.
2. Surgical Removal of Fibroids (Myomectomy)
   For women like Samantha, where fibroids are large or obstructing the reproductive system, surgery may be necessary. A myomectomy is a procedure that removes the fibroids while preserving the uterus. In many cases, this can restore fertility and help women conceive. I’ve seen numerous cases where myomectomy was the turning point for patients struggling with fibroids-related infertility.
3. In Vitro Fertilization (IVF)
   In cases where fibroids are not easily removed, IVF may be the best option. IVF bypasses the need for the fallopian tubes entirely by retrieving eggs directly from the ovaries, fertilizing them in the lab, and then transferring the embryos into the uterus. This treatment can be particularly useful when fibroids are causing blockages or altering the shape of the uterus.
4. Uterine Artery Embolization
   In some cases, a non-surgical option called uterine artery embolization (UAE) is used to shrink fibroids. This involves blocking the blood supply to the fibroids, causing them to shrink and reducing their size. While this procedure can be effective, it is not typically recommended for women who want to get pregnant, as it can affect the uterus’ ability to carry a pregnancy.

A Success Story: Samantha’s Journey

After a thorough discussion of options, Samantha and I decided that surgery to remove the fibroid was the best choice for her. The procedure was successful, and we were able to remove the fibroid without compromising the integrity of her uterus. A few months later, we started IVF treatment.

When Samantha finally saw that positive pregnancy test, I could hardly contain my excitement for her. She was overjoyed—and I was too. Watching patients like her overcome the challenges of fibroids and go on to build the families they’ve always dreamed of is why I became a fertility specialist.

Dr. Jane Fisher, another colleague of mine, says, “The road to motherhood isn’t always easy, and fibroids are just one of the many obstacles women face. But with the right approach and support, women can still achieve their fertility goals.”

Conclusion: There Is Hope

Uterine fibroids don’t have to stand in the way of your fertility. With the right diagnosis and treatment, many women can successfully conceive and carry healthy pregnancies. If you’re struggling with infertility and suspect fibroids might be the cause, don’t hesitate to reach out to a fertility specialist. Early detection, treatment, and a personalized approach can make all the difference in achieving your dream of parenthood.

If you’re experiencing similar health issues, please feel free to contact us. Our team is here to offer expert advice and personalized care. We are happy to answer your questions and discuss potential treatment options.