What Are Fibroids

Fibroids (also called uterine myomas) are lumps of muscle and tissue that grow in or around the uterus. They can be tiny—too small to see on a regular exam—or they can grow large enough to change the shape of your uterus. Fibroids are usually not cancerous, but they can still cause serious discomfort and, in some cases, fertility problems.

Different Types of Fibroids

Fibroids can grow in different parts of the uterus:

• Submucosal fibroids: Grow just under the lining of the uterus. These often have the biggest impact on fertility because they can push into the uterine cavity.
• Intramural fibroids: Develop within the uterine wall. When they become large, they may alter the shape of the uterus and affect blood flow.
• Subserosal fibroids: Grow on the outer surface of the uterus. They might press on other organs, such as the bladder, but they do not always affect fertility unless they reach a significant size.
• Pedunculated fibroids: Attached to the uterus by a thin stalk. These can twist, causing pain, but often do not directly affect fertility unless they press on certain areas of the uterus.

Why Fibroids Form

Doctors do not know the exact cause of fibroids, but hormones like estrogen and progesterone seem to play a key role. Genetics also matter. If your mother or sister had fibroids, you are more likely to develop them. “Hormonal imbalances can feed fibroid growth,” says Dr. Lisa Brown, an OB-GYN specializing in women’s reproductive health. “But that doesn’t mean every fibroid will always grow. Many stay the same size for a long time.”

How Fibroids Can Affect Fertility

Not every fibroid causes infertility. Small fibroids in harmless locations may not stand in your way when you want to conceive. Still, fibroids can lead to fertility challenges by:

1. Blocking the fallopian tubes: When a fibroid is located near the entrance of a tube, it can physically block the passage of eggs and sperm.
2. Altering the uterine cavity: Submucosal fibroids can push into the uterine lining. This can make it harder for an embryo to implant.
3. Reducing blood flow: A large fibroid inside the uterine wall can reduce blood supply, limiting the nutrients an embryo needs to develop.
4. Triggering inflammation: Some fibroids release chemicals that increase inflammation in the uterus, which might interfere with embryo implantation.

Diagnosing Fibroids

If your doctor thinks you have fibroids, they may recommend an ultrasound or MRI to see inside your uterus. Sometimes, a special procedure called a hysteroscopy is used. During this procedure, a thin camera goes into the uterus so your doctor can get a close look at any fibroids or other growths. “The location of a fibroid is often more important than its size,” explains Dr. Michael Nguyen, a fertility specialist. “Even a small fibroid can cause big problems if it distorts the uterine cavity.”

Treatment Options

• Medication: Certain drugs can shrink fibroids or reduce bleeding, but these might also affect your hormone levels or stop ovulation.
• Myomectomy: This surgical procedure removes fibroids while leaving the uterus in place. It’s a good option if you want to keep your fertility, but recovery time can vary.
• Uterine Artery Embolization (UAE): A less-invasive treatment that blocks blood flow to fibroids, causing them to shrink. However, it’s not always recommended for women who still want to become pregnant because it might affect the uterine lining.
• MRI-Guided Focused Ultrasound: Uses sound waves to heat and destroy fibroid tissue. This is another less-invasive method, but its impact on future pregnancies is still being studied.

Fibroids and IVF

If you are planning to use in vitro fertilization (IVF), your doctor will likely check your uterus for fibroids. Some fibroids may not interfere with IVF at all, especially if they are small or located on the outside of the uterus. But if you have a submucosal fibroid or a large intramural fibroid that distorts your uterine cavity, your doctor may advise removing it first. “Removing fibroids before IVF can significantly boost success rates,” notes Dr. Emily Carter, a reproductive endocrinologist. “But each case is unique, so talk with your specialist about your options.”

Lifestyle and Health Tips

While you can’t always prevent fibroids, you can take steps to look after your overall reproductive health:

1. Stay Active: Regular exercise helps manage weight and keeps your hormones balanced.
2. Healthy Eating: A diet packed with fruits, vegetables, whole grains, and lean proteins supports normal hormone levels. Try to limit high-sugar or highly processed foods.
3. Manage Stress: Long-term stress can affect your hormones. Consider meditation, yoga, or whatever helps you relax.
4. Track Symptoms: Heavy or prolonged bleeding, pelvic pain, or frequent urination could be signs of fibroids. Talk to a doctor if you notice these problems.

Emotional Support

Facing fertility challenges can be stressful. It might help to reach out to others who have walked a similar path. Look for online groups, in-person support meetings, or a therapist who specializes in fertility issues. Knowledge and empathy from others can make you feel less alone.

Key Takeaways

Fibroids are common and not always a threat to fertility. But if they distort the uterus, block fallopian tubes, or reduce blood flow, they can raise the risk of infertility or pregnancy complications. The good news is that many treatments are available, from medication to surgery, and doctors can often remove fibroids while protecting—or even improving—your chances of getting pregnant. By learning about fibroids, staying proactive about medical check-ups, and maintaining a healthy lifestyle, you can give yourself the best odds for success on your fertility journey.