Can Fibroids Affect Your Chances of Getting Pregnant?

Uterine fibroids are very common, but if you have them and want to start a family, you might wonder if they can affect your chances of becoming pregnant.

Thankfully, most people who have uterine fibroids don’t have issues becoming pregnant. 

However, like any medical condition, factors can change how your body works, and fibroids can interfere with how your body carries a baby.

Let’s talk about fibroids, how they affect fertility, and what you can do about them. 

We’ll also cover how to treat them while you are pregnant and whether or not you risk pregnancy complications when you have them. 

What Is a Fibroid?

Fibroids are tumors that grow inside the muscular lining of the uterus.

They are benign (non-cancerous). Experts agree that having fibroids does not increase your risk of developing uterine cancer. 

Fibroids are made from fibrous connective tissue. They can range in size from smaller than a pea to as large as a cantaloupe.

They may also show up in different areas of the uterine muscles. 

Although fibroids begin growing inside the muscular uterine lining, they can grow so large that they bulge into other areas of the uterus and body. 

Are Uterine Fibroids Rare?

Between 20 and 80 percent of people with female reproductive organs will develop a fibroid during their childbearing years or before they reach age 50.

Many fibroids are so small that they go largely undetected. Unless you have issues with your menstrual cycle or fertility, you may never know you have them.

What Causes Uterine Fibroids?

Experts aren’t sure what causes fibroids or why some people get them, and some do not.

Fibroids grow from abnormal muscle cells, and exposure to estrogen causes them to grow larger. Long-term exposure to estrogen (from sources like a birth control pill) might cause fibroids to develop. 

Risk Factors for Developing Fibroids

The most common risk factor for developing fibroids is age — they are most common during childbearing years. Other factors can include:

• Relatives that have fibroids, especially a mother, grandmother, or sister
• Obesity
• Uncontrolled high blood pressure
• Consuming high amounts of red meat

Additionally, uterine fibroids are more common in older people and people of African-American descent. 

How Are Uterine Fibroids Diagnosed?

Some fibroids may be large enough for your doctor to detect during your routine yearly pelvic exam.

However, many fibroids are small enough that they are not detectable through a physical examination. 

To determine if you have uterine fibroids that are not detectable by a pelvic exam, your doctor may order an ultrasound.

If you’re having issues with your period (like excessive cramping, prolonged periods, and severe pain), your doctor may order a pelvic ultrasound to look for abnormalities, including uterine fibroids. 

Symptoms of Uterine Fibroids

Fibroids often go undetected and unnoticed because you can have them without experiencing any symptoms.

However, if you have any of the following symptoms, you may be suffering from uterine fibroids. 

• Heavy, long periods, or periods that last longer than eight days
• Low back pain
• Painful periods with abdominal cramping
• Bladder issues like feeling the need to pee but not being able to go
• Constipation 
• Pain while having sex
• Pregnancy complications
• Fertility issues 

If you have been attempting to get pregnant and had no success, you may wonder if fibroids could be to blame. 

Fibroids and Fertility

Not being able to get pregnant when you are trying can be frustrating, and you may begin to wonder if you are dealing with infertility.

It’s important to remember that infertility is defined as not being able to get pregnant after twelve months of trying. 

Most people with uterine fibroids will not have trouble getting pregnant. It is possible to get pregnant with fibroids and have a healthy pregnancy. 

If you’ve been attempting to get pregnant for less than a year, you may not be suffering from an infertility issue.

However, if the year mark has come and gone and you still cannot get pregnant, you will likely want to meet with your doctor to discuss fertility treatment options. Ruling out uterine fibroids will be part of your doctor’s workup. 

Fibroids and Uterine Health

In some cases, uterine fibroids grow larger and impact the ability of your uterus to sustain a pregnancy.

There are three different types of uterine fibroids. Their location in your uterus delineates them.  

• Intramural. These fibroids grow inside the muscular wall of the uterus and are the most common. Typically, these types of fibroids do not interfere with your ability to become pregnant. 
• Submucosal. These fibroids grow from the uterine muscles into the uterine cavity, where a baby would be if you became pregnant. As such, these types of fibroids can affect fertility or early pregnancy loss. 
• Subserosal. The opposite of a submucosal fibroid, these begin in the uterine muscle and push out into the area outside the uterus. These are generally not linked to fertility or pregnancy complications but, if left unchecked, can cause other health issues. 

Although it would seem like fibroids could affect your ability to become pregnant, fertility issues are usually due to other causes.

However, if your doctor determines your fibroids are limiting your ability to become pregnant, treatment options are available. 

Treatment of Uterine Fibroids for Fertility

Fibroids that disrupt your ability to get pregnant or cause you to experience painful periods should be treated. 

Birth Control

Different birth control methods, like a hormonal pill or an intrauterine device, can help regulate your periods, ease discomfort, and eliminate severe symptoms associated with fibroids. 

You won’t be able to get pregnant while you are on birth control, but you may be able to get relief and sustain a consistent period after you come off your birth control, which may help you become pregnant.

Surgery

Surgical procedures to remove larger fibroids are an option you might consider, especially if you have submucosal fibroids.

During a myomectomy, a surgeon removes your fibroids and helps prepare you to become pregnant later. 

If you have surgery, you may have an increased risk of delivering a baby via c-section when you become pregnant. You’ll also need to wait a few months before trying to become pregnant to allow your uterus time to heal. 

You can have this procedure while you are pregnant if you have a fibroid complicating your pregnancy and placing it at risk. 

Hormone Blockers

Certain hormone-blocking medications can help stop menstruation and ovulation. During this time, your fibroids may shrink. You can still become pregnant after you stop taking the hormone-blocking medication. 

Myolysis

This procedure uses a laser, radio frequency, or an electric current to shrink the blood vessels that supply blood to your fibroids. Once the blood vessels can no longer supply blood to the fibroids, they will stop growing and shrink. 

Fibroids and Pregnancy

The methods of treating fibroids in preparation for pregnancy all carry risks you should discuss with your doctor. 

If you can become pregnant with fibroids, there are certain factors you’ll need to understand about your pregnancy, labor, and delivery.

Most of the time, a person with fibroids who gets pregnant does not experience any additional risk or complication with their pregnancy. In rare cases, however, fibroids can increase the chances of certain complications. 

Fetal Growth

Your baby needs your entire uterus to grow and expand.

A submucosal fibroid that bulges into your uterine cavity could restrict your baby’s growth, leading to low birth weight. 

This is diagnosable during the second or third trimesters of your pregnancy. 

Preterm Labor

Just because you become pregnant does not mean the pain you experience from uterine fibroids will disappear.

Your fibroids will still cause pain if you have them, which could cause uterine contractions that lead to labor. 

As your baby grows and your uterus expands, there’s a larger chance of developing these contractions, and you could have them before your pregnancy is complete. 

Cesarean Delivery

If you have fibroids or have been treated for fibroids in the past, you are six times as likely to give birth via c-section than someone who does not have fibroids. 

Breech Position of Your Baby

When your baby is in a “breech” position, they are not head down in your uterus.

Breech can mean your baby is laying across your uterus or that they are angled feet first. 

Because uterine fibroids change the shape of your uterus, it could mean your baby isn’t able to position for vaginal delivery, thus increasing your likelihood of having a c-section. 

Miscarriage

If you have fibroids, your chance of miscarriage is higher than someone who gets pregnant and does not have fibroids.

It’s important to talk to your doctor about your options if you have fibroids to discuss what kinds of fibroids you have and whether or not you need treatment. 

Placental Abruption

When the placenta detaches from the uterus, the supply of oxygen and nutrients to your baby decreases.

Placental abruption can be an emergency in the early stages of pregnancy if the abruption is large. 

However, a small abruption is usually manageable with proper prenatal care. Placental abruption can increase your risk of having restricted fetal growth and preterm labor. 

While the risks of pregnancy complications are higher with fibroids, many people with uterine fibroids have successful pregnancies with no complications. In addition, research shows that uterine fibroids may shrink during pregnancy.

Will I Be Able To Get Pregnant With Uterine Fibroids?

Every person (and uterus) is different, but getting pregnant while having fibroids is not uncommon.

Having a happy, healthy pregnancy is also not uncommon while having fibroids. 

If you know you have uterine fibroids, talk to your OB-GYN about the next steps if you want to become pregnant.

They may suggest procedures for eliminating or reducing your fibroids before you try to get pregnant. 

Don’t know if you have fibroids but haven’t been able to get pregnant while trying? Talk to your doctor.

While infertility is most commonly associated with something else, you can rule out fibroids by having a routine pelvic exam and ultrasound.

Supporting a Healthy Pregnancy

When you’re pregnant, you want a stress-free, healthy pregnancy.

If you have fibroids, you can usually get pregnant and have a healthy pregnancy, labor, and delivery.  

You can’t prevent fibroids, but taking care of yourself with regular exercise, maintaining a healthy weight, and eating a balanced diet can help reduce your risk of developing them. 

References, Studies and Sources:

Fibroids | Johns Hopkins Medicine 

Uterine fibroids | Office on Women’s Health 

Uterine fibroids – Symptoms and causes | Mayo Clinic

Pregnancy-Related Fibroid Reduction | PMC