Up to 40% of all women have fibroids.
What are uterine fibroids?
Uterine fibroids are benign (non-cancerous) uterine tumors. They occur when cells in the muscle wall of the uterus grow to form a tumor mass. The medical term for uterine fibroids is leiomyomas. Fibroids can grow quite large and will often change the shape or size of the uterus and sometimes even the cervix. Fibroids can also often attach to nearby organs (usually the bladder or the bowel) but are rarely found outside the pelvic region.
There are three main types of fibroids:
- Subserosal – found in the outer wall of the uterus (55%)
- Intramural – found in the muscular layers of the uterine wall (40%)
- Submucosal – protrude into the uterine cavity (5%)
What causes the presence of fibroids?
Fibroids tend to run in families and thus if your mother, sister, or grandmother had them it is likely that you may develop them. Medical research also has shown evidence that occurrence of fibroids is related to hormonal and environmental factors.
What are the symptoms of fibroids?
Common symptoms of fibroids are:
- Heavy bleeding during or between periods that include blood clots
- Increased menstrual cramping
- Pain during intercourse
- Increased urination
- Swelling or enlargement of the abdomen
- Difficulty or pain with bowel movements
How do fibroids affect fertility?
The size and location of the fibroid is what can affect fertility. Approximately 5-10% of women who are diagnosed with infertility have fibroids. Fibroids in women can create the following fertility challenging situations:
- If the shape of the uterus is affected due to a fibroid, it could be blocking the sperm from fertilizing the egg.
- The fibroid itself or the change it causes in the shape of the uterus can interfere with implantation of the embryo.
- The fibroid could be blocking the fallopian tube.
- The fibroid could be impacting the lining of the uterus.
- Blood flow to the uterus can be blocked, decreasing the chances an embryo will be able to implant or develop.
Can fibroids affect pregnancy?
Fibroids have also been known to cause complications during pregnancy as they can grow during pregnancy. Fibroids can outgrow their blood supply and cause a great deal of pain. They can also affect the position of the baby while in the womb. However, surgical removal of a fibroid during pregnancy is rare. If you have had a fibroid removed before pregnancy, a cesarean section is often then performed.
Treatment for fibroids is determined on a case-by-case basis because each woman’s condition is unique to her body. Treatment options include:
How are fibroids treated?
1. Surgical removal
Surgery is a viable option when distortion to the uterine cavity is caused by a fibroid. Additionally, if a fibroid is more than 2 inches in diameter and is located within the walls of the uterine cavity, removal may be beneficial. There are three types of surgeries: abdominal myomectomy, laparoscopic myomectomy, and hysteroscopic myomectomy.
2. Uterine artery embolization
This procedure obstructs blood flow to the fibroids, which then causes them to shrink. While the procedure is quite successful in reducing size and pain from the fibroid, its safety for women who are trying to conceive has not been established.
Medication intake as a fibroid treatment option is not recommended for women who are trying to conceive. This is because drugs are not effective in promoting fertility and the fibroids on the other hand also often grow back to their initial size after their use. Medications use does decrease uterine size and symptoms. Some of the used medications for fibroid treatment include: GnRH agonists (Leuprolide acetate or Lupron, nafarelin acetate or Synarel, goserelin acetate or Zoladex), progestational agents, and RU486 (mifepristone).
4. Experimental techniques
There are new therapies for treatment of fibroids that are still in experimental stages but the safety of these procedures in women who are trying to conceive has not been established. One procedure is laparoscopic myolysis in which a needle is used to apply an electrical current directly to the fibroid. The current disrupts the flow of blood to the fibroid, causing it to shrink over time. Cooled cryoprobes that destroy the fibroids is another experimental procedure. The use of magnetic resonance imaging (MRI) to target high intensity ultrasound waves has had some success as a way to destroy fibroids.
Opionato (www.opionato.com) is your trusted go-to fertility expert accessible at anytime from anywhere. We assess your fertility potential and provide next-step fertility advice so your path to pregnancy is short and stress-free.
Opionato started with one woman’s personal fertility experience and the vision to give others what she lacked. Read Maja’s story here: https://www.opionato.com/blog/what-i-wish-i-knew-my-fertility-journey.