Fibroids are very common - they are benign (noncancerous) tumors of the uterine muscle. They are also called myomas or leiomyomas. Fibroids occur when a single muscle cell in the wall of the uterus multiplies and grows to form a tumor.
The size and location of a fibroid determines whether it will affect your fertility. There are four types of fibroids, intramural (grow within the uterine wall), submucosal (grow under the lining of the uterine cavity), subserosal (grow on the outer uterine wall) and pedunculated (grow on a stalk either inside or outside of the uterus).
Although intramural fibroids, subserosal, and pedunculated fibroids may cause pain and discomfort, they generally do not affect fertility. However, if a fibroid is inside the uterine cavity (submucosal) or is larger than 5 cm in diameter, then it may impede conception.
The following are ways that uterine fibroids may impact fertility:
- They can change the shape of the cervix affecting how many sperm can enter the uterus.
- They can change the shape of the uterus interfering with the movement of the sperm or embryo.
- They can block fallopian tubes.
- They can impact the size of the lining of the uterine cavity.
- They can affect the amount blood flow to the uterine cavity thereby decreasing the ability of an embryo to implant itself to the uterine wall or develop.
Symptoms and Diagnosis
Common symptoms of fibroids include heavy bleeding and pain during a woman’s menstrual cycle, pain with deep penetration during intercourse, bladder irritability, rectal pressure, constipation and painful bowel movements.
If a fibroid protrudes into the uterine cavity, it may cause an erosion of the endometrial lining and produce irregular or continuous bleeding (menometrorrhagia). If you are trying to conceive and are experiencing an irregular menstrual cycle or excessive bleeding, you should schedule an evaluation with one of our doctors at Conceive Fertility Center. Fibroids are evaluated using a combination of physical exam and imaging techniques such as transvaginal sonogram, sonohysterogram, MRI, and hysteroscopy.
Treatment of Fibroid Tumors
Generally, fibroids are only treated if they are causing pelvic pain, bleeding or heavy or uncomfortable menstrual periods. Small, asymptomatic fibroids are generally monitored for growth instead of removing them. If you are starting fertility treatments such as In Vitro Fertilization (IVF), your doctor may recommend removing any large fibroids or submucosal fibroids in order to decrease the chance of implantation failure, miscarriage, pregnancy complications or premature labor. Intramural and subserosal fibroids are removed by laparoscopic resection or via an abdominal incision. Submucosal fibroids can be removed via hysteroscopy (outpatient surgery) which means there will be no abdominal incision and a shorter recovery time.
Most women with fibroids will not be infertile; however, it is best to consult with one of the physicians at Conceive Fertility Center to determine if your fibroids are decreasing your ability to conceive.