Uterine fibroids: How do they affect you to get pregnant?

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The existence of uterine fibroids can affect a woman’s fertility and her ability to successfully complete a pregnancy. However, this will vary mainly according to the type and size of the fibroid, as well as its impact on the uterine cavity.

We spoke to Dr. Elena Santiago about the possibilities of pregnancy with uterine fibroids.

Elena

What are uterine fibroids?

Uterine fibroids, also known as uterine fibroids, are benign tumours that develop in the uterus of women during their fertile years.

They form from the abnormal growth of smooth muscle cells in the uterus. There are several types of uterine fibroids, depending on their location within the uterus:

Classification of uterine fibroids according to their location in the uterus:

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  • Subserosal myomas: These develop in the outer layer of the uterus and can grow outwards, putting pressure on nearby organs.
  • Intramural fibroids: These form within the muscular wall of the uterus and may cause enlargement of the uterus and pain.
  • Submucosal fibroids: These are located in the inner layer of the uterus, near the uterine cavity, and can cause abnormal bleeding and fertility problems.
  • Pedunculated fibroids: These are subserosal fibroids that grow on a pedicle or stalk and can cause torsion and pain.

What test is performed to detect uterine fibroids?

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To identify uterine fibroids, the gynaecologist will carry out a pelvic examination to detect possible changes in the shape of the uterus. In addition, various diagnostic methods can be used to detect and confirm the presence of fibroids:

  • Pelvic ultrasound: This technique uses sound waves to create images of the uterus and pelvic organs, allowing the doctor to visualise any abnormalities, such as fibroids.
  • Magnetic resonance imaging (MRI): MRI provides detailed images of the uterus and surrounding tissues, making it easier to accurately identify fibroids and their location.
  • Hysteroscopy: This procedure involves inserting a thin, flexible device called a hysteroscope through the cervix to examine the inside of the uterus. It allows the doctor to detect and evaluate submucosal fibroids, which develop in the inner layer of the uterus.
  • Endometrial biopsy: This is performed by taking a sample of the lining of the uterus for examination under a microscope. Although it is not specifically used to diagnose fibroids, it can be useful to rule out other uterine conditions that may cause similar symptoms.

Symptoms of uterine fibroids

Uterine fibroids can range in size from as small as a seed to as large as a basketball and can cause a variety of symptoms, such as heavy menstrual bleeding, pelvic pain, pelvic pressure and fertility problems.

It is important that women with uterine fibroids consult an assisted reproductive specialist to assess the impact of fibroids on their fertility and receive appropriate treatment.

Impact of uterine fibroids on pregnancy

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Uterine fibroids can affect female fertility by interfering with embryo implantation and proper development of the pregnancy.

Interference with implantation of the fertilised egg: Fibroids can alter the structure of the uterus and its lining, making it difficult for the embryo to implant in the endometrium. If a fibroid is located near the implantation site or distorts the shape of the uterus, it can make it difficult for the embryo to attach properly to the uterine lining, reducing the chances of pregnancy.

Compromised embryo development: Fibroids can also affect the development of the embryo once implantation has occurred. If a fibroid is located in the uterus in a way that compresses or distorts the uterine cavity, it can interfere with the proper growth of the embryo.

Relationship between uterine fibroids and pregnancy

Uterine fibroids can have several implications for pregnancy, from the risk of miscarriage to premature birth. According to Dr Elena Santiago this is how fibroids can influence pregnancy:

  • Risk of miscarriage: especially if they are located near the embryo implantation site or if they are large in size. This may be because fibroids interfere with proper implantation of the embryo in the endometrium or affect the blood supply to the developing embryo.
  • Affecting uterine growth: During pregnancy, the uterus undergoes significant growth to accommodate the developing foetus. However, the presence of fibroids can interfere with this proper growth of the uterus, which can lead to fetal growth restriction. Large fibroids can take up space within the uterus, limiting the ability of the uterus to expand.
  • Premature delivery: This can occur if a fibroid is located near the cervix and causes premature dilation of the cervix. In addition, large fibroids can distort the shape of the uterus and make it difficult for the baby to grow properly, which can trigger premature labour.
  • Fetal well-being: If a fibroid interferes with the blood supply to the uterus or compresses surrounding structures, it can affect the supply of nutrients and oxygen to the developing fetus.

 

It is important that women with uterine fibroids are followed during pregnancy and closely monitored by their medical team to detect and address any potential complications.

Consequently, fibroids are not always removed prior to the start of assisted fertility treatment. However, in certain cases, fibroid removal may be recommended to improve the chances of successful treatment.

Uterine fibroids real photos

FAQs about uterine fibroids and pregnancy

We have collected some frequently asked questions about uterine fibroids and pregnancy, here you will find all the answers from a professional as the specialist in Assisted Reproduction Dr. Elena Santiago.

Can I get pregnant with uterine fibroids?

Dr. Elena Santiago Romero explains

“Many women with uterine fibroids can conceive and carry a pregnancy to term successfully. However, in some cases, treatment may be necessary. It is important to note that submucous fibroids, which grow inside the uterine cavity, are directly related to difficulty conceiving and may require surgical intervention to improve the chances of pregnancy”.

Diferencias entre FIV e ICSI

When is it necessary to operate on uterine fibroids to improve chances of pregnancy

Dr. Elena Santiago Romero explains

“Any fibroid that directly affects the uterine cavity must be operated on. In other cases, if an intramural fibroid is large (normally >4cm) and pregnancy is not achieved with reproductive techniques, surgery should be considered”.

Can a 5 cm uterine fibroids be operated on before IVF?

Dr. Elena Santiago Romero explains

“In other cases we tend to be more conservative, but in the event of implantation failure or a history of miscarriages, surgery should be considered”.

Can uterine fibroids be the cause of a negative IVF?

Dr. Elena Santiago Romero explains

“Not in all cases, but yes, it can be one of the factors that makes it difficult to achieve pregnancy”.

Can I get pregnant by IVF with a subserosal fibroid?

Dr. Elena Santiago Romero answers

“Most of the time, yes, without any problem. In this case surgery is only considered if they are myomas with exponential growth in a short time or if they produce any symptoms”.

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