Approximately 20-40% of all women develop fibroids at some point in their lives. Fibroid development often occurs when a woman is in her 30s or 40s. Fibroids often start as small lesions but the hormone estrogen causes them to increase in size. While most fibroids are the size of a pea, they can grow to 8 inches or more. Depending on their location, fibroids can hamper blood supply and reduce the risk of conceiving. The impact of fibroids on fertility and pregnancy differ from case to case as it is dependent on the location and size of the fibroid.
How Fibroids Affect Fertility And The Chances of Conceiving
Fibroids are almost always benign (non-cancerous) masses that can occur singly or in clusters. Although they can be asymptomatic, fibroids often cause heavy menstrual bleeding and pain. Fibroids are classified according to their location – intramural fibroids which are located on the wall of the uterus, subserosal fibroids that occur on the outside of the uterus, submucosal fibroids which grow within the uterine cavity, and pedunculated fibroids which can grow inside or outside the uterus but are attached to the walls by a stalk-like structure. In most cases, only submucosal fibroids affect fertility levels although very large intramural fibroids can block the opening of the fallopian tubes and drastically reduce the chances of conceiving naturally.
Fibroids can cause irregular menstruation which has a negative impact on a woman’s fertility levels. Submucosal fibroids reduce fertility as they can damage the endometrial lining which reduces the chances of a successful implantation of an embryo. Fibroid clusters can deprive the endometrium of blood flow which reduces a woman’s chances of sustaining a pregnancy and resulting in a miscarriage. Fibroid complications such as torsion (twisting) of a pendiculated fibroid and degeneration mayrequire an emergency surgery called myomectomy. Fertility after one myomectomy procedure is approximately 50% but this drops to 15% after 2 such procedures.
Fibroid Treatment Options ToImprove Your Chances Of Conception
Women who have large fibroids or submucosal fibroids may need to have them removed prior to starting IVF (In Vitro Fertilization) and other fertility treatments. This will decrease the risk of implantation failure and miscarriage as well as pregnancy complications including premature labour. Fibroids can reduce fertility levels by as much as 70% but if it is treated, fertility can be restored. Treatments for fibroids can be surgical or non-surgical and a fertility expert would be the best person to recommend the right course of treatment. Some of the best fibroid treatments to increase fertility include:
Myomectomy is a surgical procedure for fibroid removal. Although this is a fairly common procedure, there is a 50% chance of regrowth. This drastically limits the window of opportunity for conception but it can improve a woman’s chances of having a baby.
Uterine artery embolization
A uterine artery embolization (UAE) is a non-surgical procedure in which tiny particles are injected into the artery that supplies blood to the fibroid. This causes the fibroid to shrink to the point where it completely shrivels away and fertility is restored.
Depending on the location, size, and number of fibroids, a fertility expert may recommend medications to shrink the size of the fibroids. These medications can involve a course of hormones or other drugs or a combination of the two.
Not all fibroids require treatment but observation and vigilance are important during a pregnancy as the increase in estrogen and blood flow can cause the fibroids to grow and can even pose complications to your pregnancy. Discuss the various fibroid treatment options with your fertility expert so that you can make an informed choice.
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