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Uterine fibroids

Uterine fibroids are among the most common conditions affecting women of reproductive age, but their presence does not automatically mean a woman will struggle to conceive or have a successful pregnancy.

For women who have been diagnosed with fibroids, one of the first questions is often whether the growths will affect fertility. The answer depends largely on their size, number, location and relationship to the uterus, as well as other factors that may influence fertility.

Fibroids are non-cancerous growths that develop in or around the uterus. Some women have no symptoms and may only discover them during a routine examination or fertility assessment, while others experience heavy menstrual bleeding, pelvic pressure, painful periods or reproductive difficulties.

The relationship between fibroids and fertility is therefore more complicated than simply asking whether a woman has them.

Some women with fibroids conceive naturally and carry pregnancies without major complications. Others may experience difficulty becoming pregnant, recurrent pregnancy loss or pregnancy-related problems when certain types of fibroids interfere with the normal functioning of the uterus.

Understanding that difference is important because a diagnosis of fibroids should not automatically be interpreted as a diagnosis of infertility.

What Are Fibroids?

Fibroids, medically known as uterine leiomyomas or myomas, are growths that develop from the muscle tissue of the uterus.

They can vary considerably in size. Some are as small as a seed, while others can grow large enough to alter the shape and size of the uterus.

Fibroids can also occur in different locations.

Submucosal fibroids grow toward the inner cavity of the uterus. Because they can distort the uterine cavity, they are among the types most strongly associated with fertility problems.

Intramural fibroids develop within the muscular wall of the uterus. Their effect on fertility may depend on their size and whether they distort the uterine cavity.

Subserosal fibroids grow on the outer surface of the uterus and generally have less direct impact on fertility, although very large growths can sometimes cause pressure or other complications.

Some women may have a single fibroid, while others have several.

The location can therefore matter as much as the number.

Do Fibroids Cause Infertility?

Fibroids can affect fertility in some women, but they are not a universal cause of infertility.

Many women with fibroids become pregnant naturally.

Research indicates that fibroids are associated with reduced fertility in certain circumstances, particularly when they distort the uterine cavity.

A fibroid may interfere with the implantation of an embryo, alter the shape of the uterine cavity or affect the normal movement of sperm and embryos through the reproductive tract.

In some cases, fibroids may also affect blood flow within the uterus or create an environment that makes implantation more difficult.

However, fertility is influenced by many factors.

A woman experiencing difficulty conceiving may have other conditions affecting ovulation, the fallopian tubes, endometriosis, ovarian reserve or other reproductive functions.

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Male-factor infertility can also contribute significantly to a couple’s difficulty conceiving.

For that reason, doctors generally assess the couple rather than assuming that fibroids are the sole explanation.

Location Matters

When doctors assess fibroids in relation to fertility, location is one of the most important considerations.

A small fibroid that does not distort the uterine cavity may have little or no effect on conception.

A fibroid projecting into the uterine cavity may be more significant even if it is relatively small.

This is why women should not make treatment decisions based solely on the number or size of fibroids.

Two women may each have a 4-centimetre fibroid but have very different fertility circumstances depending on where the fibroids are located.

Imaging, particularly ultrasound and, when necessary, other forms of assessment, can help doctors determine the position and characteristics of the growths.

Symptoms Women Should Watch

Fibroids can cause a range of symptoms, although some women experience none.

Common symptoms include heavy or prolonged menstrual bleeding, pelvic pain or pressure, frequent urination, constipation, lower-back discomfort and pain during sexual intercourse.

Some women may also experience abdominal enlargement that can resemble weight gain or pregnancy.

Heavy menstrual bleeding can lead to iron-deficiency anaemia, which may cause tiredness, weakness and shortness of breath.

Not every woman with heavy periods has fibroids, however.

Persistent or unusually heavy bleeding should be medically evaluated rather than automatically attributed to fibroids.

Fibroids and Pregnancy

Having fibroids does not necessarily prevent pregnancy.

Many women diagnosed with fibroids conceive and give birth without major complications.

However, certain fibroids can increase the risk of pregnancy-related problems.

Depending on their location and size, fibroids have been associated with complications such as pain during pregnancy, abnormal fetal position, placental problems, preterm birth and increased likelihood of caesarean delivery.

The degree of risk varies considerably.

A woman with fibroids who becomes pregnant should therefore receive appropriate antenatal care and discuss her individual circumstances with her healthcare provider.

It is also important to remember that the presence of a fibroid does not mean that complications will definitely occur.

Should Every Woman With Fibroids Have Surgery?
No.

The discovery of a fibroid does not automatically mean that surgery is necessary.

Treatment depends on symptoms, age, reproductive plans, fibroid characteristics and the overall health of the patient.

A woman who has small, asymptomatic fibroids and no fertility concerns may simply require monitoring.

Surgery may be considered when fibroids cause significant symptoms, distort the uterine cavity, contribute to infertility in selected cases or produce other complications.

One of the procedures used to remove fibroids while preserving the uterus is myomectomy.

Myomectomy can be performed through different surgical approaches depending on the number, size and location of the fibroids.

For women who want to become pregnant, preserving reproductive potential is an important consideration when treatment is being planned.

When Myomectomy May Be Considered

Myomectomy may be recommended in selected women where fibroids are believed to be contributing to reproductive difficulties.

This is particularly relevant for fibroids that significantly distort the uterine cavity.

However, the decision is individual.

Doctors may consider the woman’s age, duration of infertility, other fertility factors, fibroid characteristics and previous pregnancy history.

Removing fibroids does not guarantee pregnancy.

If other fertility problems are present, they may still need to be addressed.

This is why a comprehensive fertility assessment is important before assuming that surgery alone will solve the problem.

Fertility Treatment and Fibroids

Women undergoing assisted reproductive treatment, such as in-vitro fertilisation, may also need to discuss fibroids with their fertility specialist.

Not every fibroid requires removal before fertility treatment.

The impact depends on whether the fibroid changes the uterine cavity and other individual circumstances.

A fertility specialist may use imaging to determine whether treatment is likely to improve the chances of successful implantation.

The objective is not simply to remove every growth but to identify those that are clinically significant.

This distinction can help women avoid unnecessary procedures while ensuring that potentially important fibroids are properly managed.

Age Still Matters

Fibroids often receive considerable attention in fertility discussions, but age remains an important factor in a woman’s reproductive potential.

Female fertility generally declines with age, particularly because the number and quality of eggs decrease over time.

Therefore, a woman in her late 30s or 40s who has both fibroids and difficulty conceiving may require an assessment that considers both factors.

It would be misleading to attribute infertility solely to fibroids without evaluating ovarian function, ovulation and other reproductive factors.

The same applies to younger women.

A woman in her 20s or early 30s with fibroids may have good reproductive potential, particularly when the fibroids do not affect the uterine cavity.

Pregnancy Loss and Fibroids

Some studies have linked certain fibroids with an increased risk of miscarriage, particularly when the uterine cavity is distorted.

However, miscarriage can occur for many reasons, including chromosomal abnormalities and other maternal or reproductive factors.

A woman who has experienced a miscarriage should therefore receive appropriate medical evaluation rather than assuming that a known fibroid was responsible.

For women with recurrent pregnancy loss, specialists may investigate multiple possible causes before recommending treatment.

The Importance of Proper Diagnosis

One of the biggest challenges surrounding fibroids is that women may receive information from friends, social media or informal sources that does not reflect their individual medical situation.

A fibroid diagnosis should be based on appropriate medical assessment.

Ultrasound is commonly used to identify fibroids and assess their size and location.

In some cases, doctors may recommend additional imaging or procedures to obtain a clearer view of the uterine cavity.

The information obtained can help determine whether observation, medication, surgery or fertility treatment is appropriate.

Not Every Pelvic Problem Is a Fibroid

Because fibroids are common, women may sometimes attribute every reproductive or menstrual problem to them.

But pelvic pain, heavy bleeding and difficulty conceiving can have several causes.

Endometriosis, adenomyosis, ovarian cysts, hormonal disorders and problems involving the fallopian tubes are among the conditions that may produce overlapping symptoms.

This makes proper diagnosis important.

Treating the wrong condition can delay effective care and potentially waste time for women who are trying to conceive.

Lifestyle and Fibroids

There is no simple lifestyle measure that can guarantee the prevention or disappearance of fibroids.

Women should be cautious about products or herbal remedies marketed as ways to “melt,” “flush out” or permanently eliminate fibroids without medical treatment.

Some supplements may interact with medications or have other risks.

Maintaining a balanced diet, exercising regularly, managing weight and addressing conditions such as anaemia can support general health, but these measures should not be presented as substitutes for medical treatment when treatment is necessary.

When Should a Woman See a Doctor?

Women should seek medical evaluation if they experience very heavy menstrual bleeding, persistent pelvic pain, unexplained abdominal enlargement, painful intercourse, frequent urination associated with pelvic pressure or difficulty conceiving.

Anyone with unusually heavy bleeding accompanied by dizziness, severe weakness or symptoms suggestive of significant blood loss should seek prompt medical attention.

Women who already know they have fibroids and are planning pregnancy should discuss their reproductive plans with a qualified healthcare professional.

Early assessment can help determine whether the fibroids are likely to affect fertility or pregnancy and whether monitoring is sufficient.

The Emotional Side of a Fibroid Diagnosis

The emotional impact of fibroids should not be overlooked.

For women trying to conceive, hearing that a uterine growth may be associated with fertility problems can create fear and anxiety.

Some may immediately assume they will never become mothers.

That conclusion is not supported by the diagnosis alone.

Many women with fibroids become pregnant naturally or with appropriate medical assistance.

The key is understanding the individual situation rather than treating every fibroid diagnosis as an infertility diagnosis.

A Question of Individual Care

The relationship between fibroids and fertility is ultimately a question of individual circumstances.

The size of a fibroid matters, but its location may matter even more. Symptoms matter, but the absence of symptoms does not necessarily mean that treatment is required. A woman’s age and reproductive history matter, as do the fertility factors affecting her partner.

This is why blanket recommendations can be misleading.

A woman with a small, non-distorting fibroid may need little more than monitoring, while another woman with a fibroid projecting into the uterine cavity may require specialist treatment before attempting conception.

The appropriate approach is therefore assessment rather than assumption.

What Women Should Remember

A diagnosis of fibroids can sound frightening, particularly for women who hope to become mothers. But fibroids are not synonymous with infertility.

Some fibroids can interfere with conception or pregnancy, particularly when they distort the uterine cavity. Others may have little meaningful effect on fertility.

Women should therefore seek professional assessment to understand the size, number and location of their fibroids and how those characteristics relate to their reproductive goals.

Treatment should be based on evidence and individual circumstances rather than fear.

For women trying to conceive, the most important step is not simply asking, “Do I have fibroids?” but asking, “Are my fibroids affecting my fertility, and what does the evidence show in my particular case?”

That distinction can prevent unnecessary anxiety and, equally importantly, help women who genuinely need treatment receive it at the appropriate time.

As awareness of fibroids continues to grow, the conversation should move beyond fear and misinformation towards early diagnosis, informed decision-making and access to appropriate reproductive healthcare.

For millions of women, that approach can make the difference between seeing fibroids as the end of a fertility journey and understanding them as one medical issue that can, in many cases, be carefully assessed and managed.

The Traffic NG
Uterine fibroids
Animasaun Esther
The Traffic NG

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