Fibroids And Fertility

Many women will develop fibroids at some point in life, with 20-80% of women under age 50 affected. Fibroids are benign tumors that develop in the uterine wall. These growths are smooth muscle cells and connective tissue. The size of fibroids can vary from as small as a pea to as large as a watermelon. Some women may not experience any symptoms, but as many as half may experience heavy bleeding, cramping, frequent urination, and even painful sex. Uterine abnormalities like fibroids are challenging to diagnose because the symptoms are similar to other conditions like endometriosis or pelvic infections. Fibroids are especially challenging for women undergoing in vitro fertilization (IVF) treatment.

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How fibroids may affect IVF

The presence of fibroids can impact fertility in several ways. The location of fibroids within the uterus can affect the shape and strength of the endometrial lining. A uterus without abnormalities is vital for a successful pregnancy. Fibroids can also cause changes in the structure or the pelvis’s blood supply, affecting implantation and embryo development.

Can I try IVF with fibroids?

During an IVF cycle, doctors typically perform an egg retrieval and then transfer the embryos into the woman’s uterus. With both procedures, the location of the fibroid may influence how well the IVF is performed and any complications. For example, fibroids in the lower portion of the uterus are more likely to interfere with embryo transfer and cause hemorrhaging. Fibroids that grow outside the uterus can sometimes cause nerve damage to the bladder or bowel during embryo transfer. This complication may result in additional surgery or follow-up treatment. For these reasons, women with fibroids should address the condition before beginning an IVF cycle. Yes, IVF with fibroids is possible, but the success rates are much lower.

Treating fibroids before IVF

Fertility specialists may recommend surgically removing fibroids before starting an IVF cycle. In particular, submucosal fibroids need to be removed because this type of growth can block the blood flow to the uterus. The result is fewer healthy eggs available for fertilization. For other types of fibroids not to be detrimental to fertility, medical treatments such as hormone medications may be sufficient. Other options for treating fibroids include magnetic resonance imaging (MRI) guided laser ablation and embolization. In most cases, these steps will improve the quality of the eggs and increase IVF success rates.

Address fibroids for pregnancy success

Many factors affect a woman’s chance of pregnancy success during an IVF cycle. Uterine abnormalities are a significant factor, and fibroids are often at play. This, however, does not mean all women will be unsuccessful. Most women pursuing IVF can safely undergo the procedure if the fibroids do not interfere with the embryo transfer or cause significant complications. Women concerned about having fibroids during IVF should discuss the condition and make a plan before starting treatment.

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