Getting Pregnant with Uterine Fibroids: What To Know and Do
Uterine fibroids are a condition that affect many women at some time during their reproductive years. You may have them or previously had them and not even know it.
Uterine fibroids are found in 20% of women of reproductive age, but still aren’t fully understood. Although we don’t yet know the cause of them it is believed to be a combination of genetic, hormonal, and environmental factors. So what do you need to know and do if you are in the group of females suffering from uterine fibroids?
What are uterine fibroids?
These noncancerous growths develop inside and outside the uterine. There are three types: intramural fibroids (within the uterine wall), submucosal fibroids (within the wall and bulge into the uterine cavity), and subserosal fibroids (bulge outside the uterus).
Fibroids can vary in size from undetectable to the human eye to large masses that affect the size of the uterus. You could have one single fibroid or multiple fibroids that cause a large mass. Depending on how severe your case you could be asymptomatic and not even realize you have them. In these instances they are either never discovered or can be caught during another exam such as a pelvic exam or ultrasound.
Some women do experience symptoms such as:
- Pelvic pressure or pain
- Increased need to urinate
- Difficulty emptying the bladder
- Heavy periods
- Periods that last longer than a week
It is important to seek medical help if you experience any of these symptoms for an extended period of time.
How do fibroids affect fertility?
If you do suffer from fibroids and are trying to conceive you might be worried about your ability to become pregnant naturally. Usually the fibroids themselves don’t cause any issues when it comes to fertility, but it does occur in some cases.
If you are having problems getting pregnant and know that you suffer from fibroids you should discuss your condition with your doctor. Some studies have shown that 5-10% of women suffering from infertility have fibroids. Some fibroids, especially submucosal fibroids, can cause miscarriages and infertility depending on location, size, and number of masses. It is important to have a full fertility work up to verify that the fibroids are causing the infertility before treating.
Some treatments of fibroids can drastically affect your ability to get pregnant. Many women see their symptoms subside with the use of oral contraceptives or IUDs, but these prevent pregnancy while using them.
Hysterectomy and endometrial ablation are two possible treatments for extreme or recurring cases of fibroids and would mean you could never get pregnant. Therefore it is important to take into consideration your family planning when deciding treatment options.
Fibroids during pregnancy
Many women successfully become pregnant while suffering from fibroids and see no affect on their pregnancy or on the fibroids. However, there are several pregnancy complications that could be exacerbated by fibroids. The biggest concerns include:
- Preterm delivery
- Pain that requires hospitalization
- Fetal growth restriction
- Placental abruption
- Fibroid growth that affects the baby’s position in the uterus
- Need for C-section
If you suffer from fibroids during pregnancy your OB should keep a close eye on your condition. In about one-third of the pregnancies where the mother has fibroids there is some growth of the masses in the first trimester. This could be related to changes in estrogen, but more study needs to be done.
If your doctor is concerned about your fibroids during your pregnancy they may recommend treatment. Rarely is a surgical treatment performed during pregnancy, but your doctor may recommend bed rest, extra hydration, and the use of mild pain relievers to manage the fibroids.
If you are actively trying to get pregnant or considering having a child in the future and suffer from uterine fibroids, it is important to have an honest conversation with your doctor about treatment. There are options available to treat the symptoms of your fibroids and potentially shrink or remove them and still maintain your fertility.
✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.
Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).