Uterine fibroids are essentially masses of uterine cell tissues. They are benign (noncancerous) tumors, that develops in the uterus. Though generally small, they can grow large, occasionally up to 15 centimeters. Oftentimes they form in clusters. It is estimated that 20% of women may have fibroids during their fertile years.
The key factor in determining the effects of fibroids on fertility and pregnancy is the location of fibroids. Fibroids are medically termed according to their location. Fibroids that are located inside the wall of uterus are intramural fibroids, which are the most common ones. Fibroids that are located outside the wall of uterus are subserosal fibroids, which typically grow to be the largest of all types. Fibroids that are present inside the endometrial cavity of the uterus are submucosal fibroids, which are the rarest and threatening type.
Submucosal fibroids interfere the most with conception and are primarily associated with the inability to successfully carry a pregnancy to term. These fibroids can cause difficulties with embryo implantation inside the uterus, and also hampers the placenta’s placement and development. Fortunately, submucosal fibroids are relatively rare, only making up about 1 in 20 of all uterine fibroids.
Submucosal fibroids were shown in one study to decrease a woman’s ability to get pregnant by 70%. Fertility experts recommend the surgical removal of submucosal fibroids, before going through any reproductive treatments such as IVF. Myomectomy procedure is commonly used for the removal of a submucosal fibroid. It is usually done through one or more small incisions using laparoscopy, through the vagina, or by making a larger abdominal cut.
Intramural and subserosal type can create trouble in getting pregnant, depending on their location. If they are located near the fallopian tubes where the tubes attach to the uterus, making the tubes blocked, then the woman may have difficulty in conceiving. However, in most cases, women with intramural and subserosal fibroids do not have any serious fertility and pregnancy problems. The size of intramural and subserosal fibroids decides the need for treatment and removal. If they are small and are not causing any symptoms, then treatment can even be avoided.
Treatment for fibroids usually consists of surgical removal. The surgical procedure can vary according to the type of fibroid. If a woman successfully gets pregnant while having fibroids, then the growth of fibroids during pregnancy would mostly not affect the pregnancy or cause any symptoms.
In some cases, fibroids can cause a higher risk of miscarriage. Extremely large growth of fibroids can cause postpartum hemorrhage, and there might be a need for cesarean section if the growth obstructs the birth canal. In some women, fibroids may grow inside the uterus, forcing the baby to an abnormal position, which can result in fetal malpresentation. Normally, once a woman gets pregnant, fibroids are not treated.