Fibroids and infertility connection

Twenty-eight-year-old Yetunde faced challenges during her in vitro fertilisation process. The presence of fibroids made it difficult for her ovaries to be seen and accessed for egg retrieval, resulting in fewer eggs being collected. After the embryos were placed in her uterus, implantation was also problematic due to the fibroids.

Chioma, a 30-year-old, constantly suffered from heavy menstrual periods, cramps, and anaemia. She sought medical help and received some relief, but it was not sustained, and after a few months, her heavy bleeding returned. She was later diagnosed with fibroids and a thickened endometrium, which were aggravating the bleeding. There are several women like Yetunde and Chioma who are living with fibroids.

Fibroids are non-cancerous uterine growths of varying sizes. Many women develop fibroids, particularly during their reproductive years, and one main issue is the impact on fertility. They can disrupt normal uterine functions, affect fertilised egg implantation, and alter uterine blood flow. A large majority of women with fibroids may be asymptomatic and unaware of their condition.

However, when these fibroids grow in size, they can cause a variety of issues, such as heavy menstrual flow, painful menstruation, pelvic discomfort, pain during sexual intercourse, and an increased need to urinate. Furthermore, fibroids can strain the bladder, causing pain and increased frequency of urination.

Many women develop fibroids during their 30s or 40s, but fortunately, most will not have fertility problems related to them. The exact way fibroids influence fertility is not entirely clear, but several theories exist. In certain instances, they may influence fertility by contributing to recurrent miscarriages, preterm labour, and irregular bleeding between menstrual cycles.

Additionally, fibroids can alter the unborn baby’s position within the womb, resulting in malpresentation, which may complicate the delivery process. As fibroids increase in size, they can lead to abdominal enlargement, creating the appearance that the woman is pregnant.

While fibroids may affect fertility, they rarely serve as the sole cause. About 5-10 per cent of women with infertility have fibroids, but they are responsible for less than 3 per cent of infertility cases. However, fibroids can impact fertility in several ways. They may block the fallopian tubes, hindering the meeting of eggs and sperm or preventing fertilised eggs from reaching the uterus. Large fibroids can take up space in the uterus, particularly submucosal fibroids, which can affect where a baby needs to grow.

Fibroids can also change the shape of the cervix, making it more difficult for sperm to reach the uterus. They may block the fallopian tubes, making it hard or impossible for a fertilised egg to attach. Fibroids can alter the shape of the uterus, limiting where an embryo can implant or reducing the space available for its growth. They can weaken the uterine lining, leading to miscarriages, and they might decrease blood flow to the uterine cavity, which can harm the endometrium’s development, hinder the implantation of an embryo, and lower the chances of a successful pregnancy.

The treatment for fibroids includes several options. One method is high-intensity focused ultrasound, a minimally invasive procedure that uses high-intensity ultrasound waves to target and destroy fibroid cells without harming surrounding tissue, helping to maintain uterine function and fertility. The HIFU treatment for fibroids takes place in a special machine that produces sound waves, and the doctor focuses on one small section of a fibroid.

Since fibroids can pose challenges, their removal can relieve pain, discomfort, heavy bleeding, and bloating. It also preserves the uterus, making it ideal for women who want to become pregnant. About 5-10 per cent of women who struggle with infertility also have fibroids. Large fibroids or those located inside the uterine cavity might hinder the ability to conceive and carry a healthy baby. They can also block the fallopian tubes.

Most women with fibroids do not experience infertility. If there are concerns, it’s essential to explore other factors that might affect fertility before considering fibroid treatment. A fertility specialist can assess whether fibroids are contributing to fertility issues and determine if treatment is necessary. Uterine fibroids can interfere with fertility in various ways depending on their size and location, which can affect the uterus, cervix, or fallopian tubes. For instance, fibroids can block the fallopian tubes, preventing a fertilised egg from implanting. Fibroids may also affect the thickness of the uterine lining, and blood flow to the uterine cavity can change, reducing an embryo’s chances of implanting or developing.

Deciding on fibroid treatment should depend on the circumstances, such as the severity of symptoms and the presence of other infertility factors. While various treatment options exist, only surgery can permanently remove fibroids. Other methods, such as ultrasound or medication, may only reduce fibroid size temporarily and could allow new fibroids to develop.

When it comes to improving fertility, the removal and management of fibroids can lead to higher pregnancy and live birth rates. It’s wise to monitor fibroids during pregnancy, as they may grow and lead to complications. If you and your partner are having difficulty conceiving, both should undergo fertility evaluations to investigate all potential causes, including fibroids.