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Can fibroids prevent you from getting pregnant?

Can fibroids prevent you from getting pregnant?

Nicole Knight, AHCJ | March 3, 2021 | trying to conceive
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It’s natural to feel concerned if you suspect you have uterine fibroids. First off, know you’re not alone. As many as 1 in 4 women have fibroids during their reproductive years, and the growths, which are usually not cancerous, are even more common among African American women (1). 

Even though they’re not normally malignant, fibroids may affect your fertility in multiple ways. Between 5-10% of infertile women have fibroids. And fibroids with specific characteristics are more closely linked to infertility and pregnancy complications (2).

Whether you have a sneaking suspicion you have a fibroid or you’ve been diagnosed by a practitioner, here’s what you need to know about these growths and your fertility. We’ll also break down whether fibroids can harm your growing baby once you’re pregnant and if it’s possible to get rid of them naturally.

What are the symptoms of fibroids?

About half of fibroids are symptomless, meaning it’s possible to have one without any sign of it. However, if you suspect you have fibroids, be on the lookout for the following signs (3):

  • Longer, heavier periods
  • Bleeding between periods
  • Feelings of pressure
  • Menstrual cramps
  • Lower back pain 
  • Abdominal pain (Usually dull, but can be sharp)
  • Pain during sex
  • Swollen abdomen or uterus
  • Frequent urination or difficulty urinating
  • Constipation, pain, or trouble with bowel movements

Some women with fibroids have so much bleeding they become anemic. Infertility or miscarriage also may be warning signs of fibroids, although the good news is most women with fibroids are fertile and can conceive even with fibroids (3). 

Can fibroids prevent pregnancy?

Of the 5-10% of women with fibroids who aren’t getting pregnant, one or more of the following factors may be to blame (2):

  • Number of fibroids
  • Size
  • Location 
  • Type

For example, roughly 55% of fibroids are categorized as submucosal fibroids. This type of fibroid can jut into the uterine cavity, increasing the likelihood of infertility and pregnancy loss (2). 

Another type, an intramural fibroid, grows in the uterus' muscular layer. If these intramural fibroids grow quite large (larger than 6 centimeters in diameter), they may distort the uterine cavity in a way that harms fertility. For example, the fibroid might change the shape of the uterus or alter blood flow within the uterus. These changes could interfere with the movement of sperm, hinder implantation, or impair the development of the fertilized egg. Or a fibroid could potentially block the cervical canal or fallopian tubes, which could also prevent conception (2). 

Too many fibroids also may make conception more challenging. According to a 2018 paper in the Journal of Minimally Invasive Gynecology, study participants with 6 fibroids or more were significantly less likely to conceive than those with fewer fibroids (4).

Do fibroids cause miscarriage?

As we mentioned, miscarriage is considered one of the symptoms of fibroids. However, whether fibroids actually cause miscarriage is less clear. The American Society of Reproductive Medicine's 2017 committee statement noted “insufficient evidence” that fibroids cause early pregnancy loss and called for more research. Thus far, the findings we have are mixed (5). 

One large study didn't find a difference in miscarriage risk among 5,500 women with and without fibroids. However, one small study found a higher likelihood of miscarriage (14% compared to 7.6%) in 143 pregnant women with fibroids (5).

(How long do you have to wait after miscarriage to try again?)

Can I get rid of fibroids naturally?

Fibroids appear to be linked to a surplus of the hormone estrogen, among other biological, environmental, and genetic factors. Maintaining a healthy weight and making nutritional changes may help to moderate estrogen levels, which may help reduce fibroids. For example, you may wish to talk to your provider about the effectiveness of curbing your intake of soy-based food. A recent meta-analysis found an increased risk of uterine fibroids among women who’d eaten a lot of soy products. Some doctors recommend going easy on red meat and ham, due to a possible link to fibroids. (6, 7, 8).

To avoid developing fibroids, make sure you’re getting the recommended amount of Vitamin D. A 2020 meta-analysis of 9 studies with a total of 1,730 participants found that women with uterine fibroids had significantly lower levels of the sunshine vitamin in their blood than women without fibroids (9).

Want to learn more about getting pregnant?

Download Free E-Book  "How To Not Waste Another Month Trying to Conceive"

How are fibroids treated?

Small, symptomless fibroids typically don’t require treatment. For fibroids causing painful, heavy periods, the American College of Obstetricians and Gynecologists (ACOG) generally recommends starting with some form of hormonal treatment, such as (3):

  • Oral contraceptive
  • Progestin–releasing intrauterine device (IUD)
  • Gonadotropin-releasing hormone agonists (drugs that cause your body to produce less estrogen)

These options, however, are counterproductive if you’re trying to get pregnant. 

(Curious about natural options to help regulate your flow?)

Certain surgical procedures can either shrink or eliminate fibroids. Generally, surgical options are recommended on a case-by-case basis given the various types, sizes, and locations of fibroids and the ways the growths may affect reproductive health (2, 3). 

Surgical options to remove fibroids include (3):

  • Hysteroscopy: a probe zaps the fibroid with a burst of electric energy or laser light to eliminate it
  • Uterine artery embolization: cuts off blood flow to the fibroid to shrink it
  • Magnetic resonance imaging-guided ultrasound surgery: uses ultrasound waves to destroy the fibroid
  • Myomectomy: surgical removal through a cut in the abdomen or via a device inserted through the vagina
Does fibroid treatment affect fertility? 

Surgical removal of several fibroids may affect your ability to conceive. In one study, women who had 6 or more fibroids surgically removed were significantly less likely (22.9% vs 70.8%) to get pregnant than women who had fewer than 6 removed. The women in the study had robotic, laparoscopic, or abdominal myomectomy to remove the fibroids (4).

More recently, a 2020 nationwide study showed a sharply higher risk of cesarean section and uterine rupture in women who’d had myomectomy compared to women without a diagnosed fibroid. The risk was highest within one year of the myomectomy and lessened over time (1).

Before opting for any fibroid treatment, discuss your family planning goals with your provider to make sure you’re making the best choice for your future.

Do fibroids harm my baby once I’m pregnant?

The chief concern with pregnancy and fibroids is the possibility that a fibroid might increase the chance of miscarriage or preterm birth. For example, a cavity-altering fibroid that distorts the uterus may change a growing baby’s position in the uterus, potentially heightening the risk of miscarriage or preterm delivery. It may also make a cesarean section more likely. Rarely, however, will doctors suggest removing fibroids during pregnancy (2).

If you’ve been diagnosed with fibroids while pregnant, it’s important for you and your provider to come up with a plan to help avoid complications and put you on a path to the healthiest possible pregnancy. Rest assured, in the vast majority of cases, a fibroid diagnosis doesn’t necessarily mean your baby-making dreams are over.

References +
How Not to Waste Another Month When Trying to Conceive
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