Fibroids can raise concerns for individuals hoping to start a family. If you’re trying to conceive or facing fertility challenges, you might wonder: Can fibroids cause problems during pregnancy?
The answer is that it depends. Below, we examine fibroids during pregnancy and their potential impact on fertility.
What Are Fibroids?
Fibroids, also known as benign smooth muscle cell tumors are non-cancerous growths, typically in the uterus. These growths can vary significantly—from one millimetre to 20 centimetres (or larger). In other words, they can be as small as a seed or as big as a grapefruit. Some patients may have a single fibroid, while others have multiple.
What Are Uterine Fibroids?
Uterine fibroids are fibroids that specifically grow in the uterus. They’re quite common, affecting 40-60% of individuals by age 35 and 70-80% by age 50. And many fibroids may go undetected, even with an ultrasound. This is because they can resemble the natural growth of the uterine wall. But this doesn’t mean they’ll always cause issues. Their impact on fertility and pregnancy depends on size and location.
Different types of uterine fibroids include:
Intramural fibroids: These are the most frequent type. They grow within the muscular layers of the uterine wall.
Submucosal fibroids: This type of fibroid develops beneath the inner surface of the uterus and can extend into the uterine cavity.
Subserosal fibroids: These form on the outer uterine wall. They can grow large and extend outward into the pelvic region.
Pedunculated fibroids: These are the least common type of fibroid. In this case, the fibroid is attached to the uterus by a “stem,” often resembling a mushroom shape.
What Are the Symptoms of Uterine Fibroids?
Many patients with fibroids never experience symptoms. Meanwhile, others may have:
- Heavy bleeding
- Pelvic pain
- Frequent urination
- Bloating or feelings of fullness in lower abdomen
- Painful intercourse
- Low back pain
- Increased vaginal discharge
Fibroids and Fertility
Ultimately, the effect of fibroids on fertility depends on the size, number, and location. Problems with conceiving may happen when fibroids interfere with the sperm reaching the egg—or if they affect the implantation of the embryo on the uterine wall. This often means that submucosal fibroids are most likely to cause fertility issues.
For IVF patients, large fibroids may get in the way, interfering with or preventing access to the ovaries.
However, many assigned females at birth with fibroids conceive without issue. Fertility treatments can also be effective even with fibroids present. Consulting a reproductive specialist, such as our team at TRIO, can provide personalized insights and treatment options—guiding your fertility journey and helping you achieve the family of your dreams.
Fibroids and Pregnancy
It’s rare for fibroids to interfere with pregnancy as they either remain the same size or shrink a little. However, with changing hormones, the rise in estrogen during pregnancy may cause the fibroids to grow within the first three months (the first trimester). In rare instances, fibroids may cause a miscarriage (pregnancy loss in the first 23 weeks). But, again, this is rare.
At the same time, it can help to be aware of the potential risks. So, let’s take a closer look.
Fibroids During Pregnancy
Approximately 10-30% of those with fibroids develop complications during pregnancy. Early on, bleeding and miscarriages may occur. It’s more likely that preterm labour (early labour) may also happen. Below, we explore these risks and how to manage them effectively.
Fibroids During Pregnancy Risks
During pregnancy, fibroids may increase the risk of:
Placenta abruption: This is when the placenta separates from the uterus, decreasing or blocking the delivery of oxygen and nutrients to the fetus.
Placenta previa: This occurs when the placenta grows in the lower portion of the uterus, near the cervical opening. Occasionally, this may fix itself. In some cases, other precautions may need to be taken, such as having an early scheduled C-section.
Fetal growth restrictions: Large fibroids might affect how a baby grows in the womb. This can sometimes lead to problems, such as torticollis or limb defects.
Breech birth: This happens when the baby comes out feet or bottom first instead of head first.
Larger fibroids may also block the vagina. In these cases, a C-section is also necessary.
Managing Fibroids During Pregnancy
If you have pain, your doctor might suggest resting in bed. They may also recommend specific pain medications to help ease any discomfort. Additionally, your doctor will monitor you with regular ultrasounds to track fibroid and fetal growth.
Treating Fibroids During Pregnancy
Fibroids don’t usually need to be treated during pregnancy. Most doctors avoid invasive treatments while pregnant. Thus, symptom management including pain management is the primary focus. As your pregnancy moves forward, you and your doctors will make a plan. This might include deciding if you need a C-section.
If you have concerns about fibroids and conceiving, our team at TRIO is here to help you. We have the largest in-house team in Canada and are committed to each patient’s success. Talk to a member of our team to learn more.
FAQs
Can I get pregnant if I have fibroids?
Yes, many individuals get pregnant despite fibroids. If fibroids make it hard to get pregnant, talk to a fertility doctor. They can help you determine the best path forward.
Is it safe to get pregnant with fibroids?
Fibroids’ size, number, and location can impact your pregnancy outcomes. In most cases, however, many individuals go on to have a healthy and safe pregnancy with fibroids.
References:
https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876319/
https://www.webmd.com/women/uterine-fibroids/what-if-i-have-uterine-fibroids-while-pregnant
