Welcome to our medical blog! Today we delve into an important issue that affects many women globally – the impact of fibroids on fertility.

Fibroids are benign tumours that occur in the uterus, and while they are common and often symptomless, they can sometimes complicate the process of conception. Let’s discuss this topic in detail.

Fibroids and Pregnancy: Not Always a Barrier

Firstly, it’s crucial to dispel a common misconception: having fibroids doesn’t mean you can’t conceive. It’s perfectly possible to get pregnant even if you have fibroids.

However, in some cases, these benign growths can indeed make it challenging to conceive.

But remember, the inability to conceive isn’t always directly attributable to fibroids; multiple factors can contribute to fertility issues.

How Fibroids Can Impact Fertility?

When it comes to understanding the intricate relationship between fibroids and fertility, it’s important to grasp how fibroids can potentially disrupt the conception process. Let’s delve deeper into each of these points:

• Location Matters: The location of fibroids plays a significant role in their potential impact on fertility. If fibroids are situated near the fallopian tubes, they can lead to blockages, which can hinder the normal functioning of these crucial pathways.Fallopian tubes serve as conduits for the eggs to travel from the ovaries to the uterus. If blocked or obstructed by fibroids, this travel can be disrupted, creating difficulties in the fertilization process and, consequently, in conception.
• Distorting the Uterus Lining: Fibroids can also cause complications when they grow within the uterine cavity. They can lead to a thinning of the endometrium, the uterus lining, and decrease the blood supply. This situation is problematic as a thick and healthy endometrium is vital for the successful implantation of an embryo.A reduced blood supply can further impair the nourishment and growth of the embryo, thus impacting successful conception.
• Distortion of the Uterus: Larger fibroids have the potential to alter the physical shape of the uterus significantly. When these fibroids grow inwards, they can distort the uterus, thereby decreasing the chances of successful conception.A distorted uterine structure can interfere with the implantation process and can also affect the growth and development of the embryo.
• Impacting Semen Transit: At times, fibroids can cause the cervix — the lower part of the uterus that opens into the vagina — to shift from its natural position. This displacement can make it challenging for the semen to travel into the uterus and further up to the fallopian tubes, where fertilization typically occurs. This disruption in semen transit can contribute to difficulties in achieving pregnancy.

Treatment Options for Fibroids

Once we understand the potential ways fibroids can affect fertility, it becomes important to explore the available treatment options:

• IUI Procedure: An important thing to remember is that not all fibroids necessitate removal. Even in the presence of fibroids, conception is possible with the help of techniques such as Intrauterine Insemination (IUI). IUI is a fertility treatment that carefully places sperm inside a woman’s uterus to facilitate fertilization. By introducing the sperm directly into the uterus, it is given a beneficial “head start”, although it still requires the sperm to reach and fertilize the egg independently.
• Myomectomy: For cases where the fibroid is near the fallopian tube or is distorting the uterus’s opening, a surgical procedure known as myomectomy may be recommended. Myomectomy focuses on the precise removal of fibroids while preserving the uterus, ensuring future chances of conception remain intact. It proves to be an effective option in cases where fibroids are the primary barrier to conception.
• Adhesion Risks Post-Surgery: It is critical to remember that even after a myomectomy, natural conception isn’t always guaranteed. At times, the surgical procedure can cause adhesions or scar tissues, which can block the fallopian tubes. This blockage can further impede the travel of eggs and sperm, making natural conception challenging. In such cases, Assisted Reproductive Technologies (ART) such as in vitro fertilization (IVF) may be needed.
• C-Section Post-Surgery: Another aspect to consider is that when surgery is performed to remove fibroids (which often involves making an incision in the uterus), a Caesarean section (C-section) might be required during delivery. This consideration is particularly important for women who are planning for pregnancy and need to be aware of the potential childbirth complications post fibroid-removal surgery.
• Medicinal Intervention: A common query we encounter is about the role of medication in treating fibroids. It’s important to clarify that while certain medicines can temporarily shrink fibroids, they cannot eliminate them completely. Medicines can be used to manage symptoms of fibroids, but for permanent removal, surgical intervention is typically required.

The Bottom Line

Each case of fibroids is unique, and the treatment depends on the size, location, and number of fibroids, among other factors. The presence of fibroids doesn’t automatically mean that conception will be impossible or even difficult.

It’s Time to Take Action!

Fibroids and fertility can seem like a complex and daunting issue. However, armed with the right knowledge and medical advice, you can navigate this path successfully. The most important step is to stay informed and proactive. If you’re dealing with fibroids and planning to conceive, consult with our fertility experts to understand your situation better.

Our team is equipped with the knowledge and experience to guide you on your fertility journey, addressing your unique needs and circumstances. Remember, every challenge is surmountable when approached with the right mindset, guidance, and medical expertise.

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• About Author

  Dr. Supriya Puranik

  Gynaecologist & IVF Specialist

Often known as the last glimmer of hope for people who have lost all hope for conceiving a child, Dr. Supriya Puranik is a leading gynaecologist, high risk obstetrician and Head of IVF & Gynaecology department at Ankura Hospital for Women & Children.