The ‘F’ words: Fibroids, Fertility and the Facts

For many, conversations about fertility can lead to panic surrounding our ability – or rather our inability to get pregnant or carry a pregnancy to term. With fertility becoming a sort of new ‘F’ word, dealing with the additional burden of hormonal conditions that can impact fertility can leave us feeling overwhelmed.

This F-word anxiety is often experienced by women who have fibroids. But, is the concern really valid? Up to 10% of women who struggle with infertility do have fibroids, but with 2 in 3 women globally impacted by these uterine growths, the question of whether fibroids cause infertility or are simply a part of being a uterus owner remains.

In this blog post, I’m getting down to the brass tacks of how fibroids and fertility affect each other. I’ve got you covered on all the things you should consider when trying to conceive with fibroids, along with a host of other facts that will come in handy even if fertility isn’t the top of your agenda. So, let’s dive in!

The short answer here is yes! Having fibroids doesn’t mean you can’t get pregnant or have babies, but it does mean you will need to take a few extra steps when planning your route to conception.

Depending on the quantity, location, and size of your fibroids, these benign growths can cause a physical barrier that impacts the sperm’s ability to fertilize eggs.

Fibroids can also make it more challenging for fertilized eggs to properly implant in the uterus, and in turn, for the uterus to properly accommodate a growing fetus. Very large fibroids in particular can interfere with a baby’s ability to grow, as they can take up much of the already limited room in the womb.

Additionally, if fibroids grow in such a way to block the birthing canal, expectant mother’s will need to plan for a cesarean section (C-section) delivery.

As with most big decisions, it’s a good idea for you to see your doctor if you’re trying to get pregnant.

If you are struggling to conceive, it’s important to remember that fibroids may not be the main factor impacting your fertility.

A doctor can help you to understand what other elements could be impacting your ability to get pregnant. They will also be able to offer solutions to help address any issues they find!

If it does so happen that fibroids are the cause of fertility concerns, you may need to undergo treatments to help shrink them, or have them removed in order to improve your chances of getting pregnant.

Whether you choose to keep or remove your fibroids before getting pregnant is an important choice.

If you choose to have your fibroids removed, getting and staying pregnant is usually pretty smooth sailing, following recovery from the removal process. However, there are some very rare but serious complications that can occur after a surgical fibroid removal.

Following the removal of fibroids, women who go on to get pregnant may experience preterm labor and heavy bleeding during and after delivering their baby. The surgical removal of fibroids also increases the chances that you’ll need to have a C-section.

Another rare outcome involves scarring in the uterus that impacts future fertility. Fortunately, this scarring can be easily treated to reverse the effects, but it will add to the overall time you need to recover before you can try to get pregnant.

While the benefits of surgical fibroid removal does outweigh the risks, it’s not always recommended.

If your doctor predicts that your fibroids will not cause significant issues to a growing baby, alternative treatment methods that are less invasive will probably be recommended. For instance, a uterine artery embolization (UAE) is a non-surgical procedure that restricts blood flow to the fibroids, causing them to shrink.

On the other end of the spectrum, if you have many fibroids, or if your fibroids are very large, surgical removal may be too risky, due to potential blood loss. Doctors will likely advise against the removal of fibroids in the case that cancer is also present in the uterus. In this scenario, they may instead suggest cancer treatments or a hysterectomy.

If you opt not to have your fibroids removed, you will want to monitor your pregnancy a little more carefully. The presence of fibroids can affect the placement of the placenta, the placement of the baby, and can potentially bring your delivery date forward. In some cases these factors will also result in us needing to have a C-section.

In more positive news, while having fibroids had previously been thought to be associated with having a higher chance of miscarriage, more recent research shows that rates of miscarriage are actually similar between women with or without fibroids! So that’s ‘F-word’ worthy wonderful!

Interestingly, evidence shows that fibroids can both shrink and grow during a person’s pregnancy!

Whatever the case, it’s a good idea to keep an eye on how your fibroids are changing as your pregnancy progresses. If your fibroids grow during pregnancy, it may be seen as a reason to have a C-section, as opposed to a natural birth.

Pregnancy also affects the ways in which you experience and are able to manage fibroid symptoms. For instance, some women with fibroids will have used hormonal birth control to help regulate their heavy bleeding and pain.

While heavy bleeding should not be a concern for pregnant women, those who continue to experience fibroid-associated discomfort will need to turn to alternative methods of pain relief, as hormonal birth control is a no-no for pregnant women.

For women who have fibroids and are not looking to get pregnant, you may be wondering which methods of birth control you should use, and whether having fibroids will impact this decision.

Bottom line? There seems to be a lack of agreement in the scientific community as to whether those living with fibroids should take particular kinds of hormonal birth control.

Some experts think these medications are beneficial in helping to shrink fibroids, while others suggest that added hormones could contribute to fibroid growth.

Overall, the effect of hormonal birth control on fibroids varies from person to person. This variation happens in part because different medications contain different quantities of the hormones progesterone and estrogen.

Evidence shows that both estrogen and progesterone can contribute to fibroid growth, which is why doctors may be hesitant to prescribe certain birth control pills that contain large doses of these hormones.

For fibroid-friendly family planning methods, have a chat with your doctor, as they may suggest alternatives like birth control pills containing lower doses of estrogen and progesterone, or non-hormonal intrauterine devices (IUDs).

Having fibroids doesn’t just affect the choices you make when getting pregnant. It also affects the choices you make when choosing not to remain pregnant.

The size and shape of fibroids can make it difficult for doctors to perform a surgical abortion, meaning that those seeking to end a pregnancy will need to use alternative methods such as oral medications. Such medications must be taken less than 11 weeks after your last period in order to be effective.

These types of medications are also popularly used by women to help cope with miscarriages. Interestingly one of these medications has also been shown to be effective, when taken regularly at very low doses, to relieve fibroid-induced discomfort, and even to reduce the size of fibroids in some women.

If the topic of fertility still makes you nervous after reading this, I don’t blame you. Making decisions about any health related care can feel overwhelming, no matter what. It can be especially emotional if you’ve always dreamed of getting pregnant and having a family.

Worrying about how fibroids will impact your fertility can also be lonely, particularly if you aren’t sharing your concerns. As hard as it can be to talk to your doctor about your fertility, ignorance about this aspect of your health is definitely not bliss. The best thing we can do to reduce our anxiety is to take control and start a conversation with someone who can help us.

The good news is that many options are available for women who have fibroids. There are also many considerations related to some of these options, which is why it’s so important to talk to your doctor so you know where you stand, and what will work best for you.

Also, there is no time like the present. Some fibroid-fertility treatments are time sensitive, and some will require long recovery periods. Seek out medical care early so you can achieve your goals as soon as possible. Even if you aren’t planning to be pregnant in the near future, get ahead of the game! Start treating your fibroids now to prevent potential complications in the future.

Fertility may always be an F-word, but let’s break the taboo! Talk to your doctor, know where you stand, and get support on your fertility journey!

Your future self will thank you.