Gynaecologist's View on Fibroids & Fertility

Are all your attempts to get pregnant failing lately? Maybe because fibroids are the reason. We are now getting directly into it.

Fibroids are non-cancerous, tiny to large growths in and around the uterus. They are very common, and many women aren't even familiar with the fact that they have fibroids. Most fibroids don't have symptoms, and since uterine scans are not as common in India, the unfamiliarity remains. It only comes around when doctors associate fibroids & fertility together, causing a roadblock in the way of conception.

Here's what gynaecologists think every female should know about fibroids & fertility. Skip the fear and learn about your body.

What are fibroids, and why do they develop?

Fibroids are non-cancerous lumps made of muscle and connective tissue, just like any lump in your body. They grow inside and around the womb (uterus). These lumps grow slowly and can vary from a millimetre to the size of a lemon or even bigger. Some women may never notice symptoms, whereas others may feel pain, pressure and heavy bleeding.

Types of fibroids

Doctors classify fibroids into four types based on where they grow:

1.      The intramural fibroids are the most common and they grow inside the uterus wall.

2.      The submucosal fibroids are slightly concerning as they grow just under the lining of the uterus.

When talking about fibroids & fertility, submucosal growth is more worrying.

3.      Next are subserosal fibroids that grow on the outer surface of the uterus.

4.      Whereas the last, pedunculate fibroids grow on a stalk either inside or outside of the uterus.

But why do fibroids develop?

Fibroids can be single or multiple, and the more there are, the more likely they are to cause symptoms. Medical science doesn't know the exact reason for uterine fibroids, but there are some common factors gynaecologists talk about:

Hormones: Female hormones like oestrogen and progesterone encourage fibroid growth. These hormones make the uterus lining and prepare the womb for pregnancy. Since fibroids are made from the same muscle tissue as the uterus, there is a high chance that they respond to these hormones.

Genetics: Like many reproductive similarities, fibroids are also more likely if your mother or sister has had them.

Age: Many females in their 30s and 40s can develop fibroids as their hormone levels are usually at their peak. Since their uterus is very active for reproduction, and fibroids feed on the same hormones as for fertility, they can likely grow. Therefore, the risks drop after the mid-40s or after menopause.

Lifestyle links: A bad lifestyle is the most common reason for most health issues, including fibroids in the uterus. Lack of exercise, poor diet, and obesity may cause fibroids to grow faster and larger.

How do fibroids affect a woman’s fertility and pregnancy chances?

Yes, since fibroid & fertility is the main question, let's now get into it. Fibroids are lumps growing in and around the uterus, and they can be harmless or harmful. When fibroids grow large or right under the uterus lining, they may cause pressure on the fallopian tubes. This, as a result, can block the pathway for sperm to travel and meet the eggs.

Similarly, fibroids can change or deform the shape of the uterus, making it harder for the sperm to reach the eggs. Submucosal fibroids are most likely the ones responsible here.

At times, large and heavy fibroids reduce the blood supply to the uterine lining, making fertility less likely.

Note: Women with tiny fibroids outside the uterine cavity can still conceive naturally.

Can fibroids become a stress during pregnancy?

Female hormones rise sharply during pregnancy, making fibroids grow faster. While they won't likely bring a lot of complications, women do worry if the baby will have enough space in the uterus to grow normally.

Still, fibroids during or outside pregnancy can be painful and heavy in the abdomen. Once fibroids outgrow their blood supply, they will cause sharp pain. Sometimes, women experience spotting, bleeding or contractions.

The only possible risk that one should be worried about is the large fibroids pushing the baby into an unusual position. Or, they may block the birth canal, increasing the need for a C-section.

When should a woman with fibroids seek medical help for fertility?

Although women should regularly go for a uterine scan, if it is specific about fibroids, here's when you must see a gynaecologist at Bliss Fertility:

Not all uterine fibroids need treatment, and you must be alert when –

• Experiencing heavy and prolonged bleeding during the menstrual phase.
  

• Constant pain or pressure in the pelvic area.
  

• Frequent need for urination as fibroids are likely pressing your bladder (or bowel thus causing constipation).
  

• Acute cramps are not even relieved by routine painkillers.
  

•  Abnormal pain during intercourse.
  

Or, in case you see signs that lead to these concerns about fibroids & fertility –

• Repeated miscarriages, even when your reproductive health seems fine.
  

• Difficulty in getting pregnant even after trying for a few months or a year.
  

• Irregular or short menstrual cycles disturb ovulation.
  

• A history of hauled IVF cycles (but your fertility specialist may know about this).
  

Managing/ Treating Fibroids For Fertility

Fibroids are tiny obstacles in the road to fertility, but the good news is they have treatment at Bliss Fertility:

• You may benefit from hormonal medications like GnRH agonists, progestins, etc. They shrink fibroids to control heavy bleeding and clots.
  

• Specialised doctors in Bliss fertility may suggest pain relief medicines to manage cramps and discomfort.
  

Note: But medicines don't usually remove fibroids permanently; inside, they can only shrink the size and help with symptoms.

• In some cases, doctors may suggest 'Myomectomy', the surgical removal of fibroids. It is usually a way of fertility preservation. The surgery can be performed via laparoscopy (keyhole), hysteroscopy (inside cavity), or open surgery.
  

Conclusion

Overall, if you have fibroids and you are concerned about getting pregnant, avoid self-analysis and visit an expert at Bliss fertility. Fibroids & fertility are still a big question, but you can still conceive naturally or with assisted treatment.

Still unable to find the right guidance on Fibroids & fertility? Meet the top gynaecologists of Kerala at Bliss Fertility. Ask questions and stay informed. Call Now

+91 62 62 62 32 62 (Kottayam & Maldives) +91 88 22 55 66 33 (Tirur) +91 99 47 70 00 06 (Trivandrum)

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