It is estimated that 1 in 10 women in the United States have difficulty getting pregnant or staying pregnant.¹ While not uncommon, experiencing fertility issues can feel incredibly isolating and can take an emotional toll on women and their partners, especially as they seek to understand the underlying cause and explore treatment. Infertility and pregnancy complications can be caused by a number of factors – one of which being fibroids. As fibroids affect between 70% and 80% of women (and don’t always show symptoms), it is super important for women to be aware of their potential impact on fertility.^2,3

In honor of National Infertility Awareness Week, let’s break down the facts about fibroids and fertility to empower women to have informed conversations with their doctors about the role their fibroids may play in getting pregnant.

First of all, what are fibroids?

Fibroids are non-cancerous growths inside the uterus that often appear during childbearing years. Though not all fibroids will cause symptoms, often causing them to go undiagnosed, some women may experience heavy and painful periods and frequent urination, among other symptoms. Fibroids can come in many shapes, sizes, and locations within the uterus and these factors can cause you to feel different types of symptoms, or in some cases, no symptoms at all.

Why do women get fibroids?

Certain factors can increase your risk for developing fibroids. Black women are more likely to have fibroids, develop fibroids at a younger age, have multiple fibroids, larger fibroids, and experience worse symptoms than other women.² Fibroids are also hereditary, so if your sister or mother has them, it’s likely you may, too.² Other factors can increase your risk as well, such as diet, obesity, and how old you were when had your first period. Despite the fact that many fibroids go unnoticed, approximately 6.5 million women seek treatment for the condition each year in the U.S.⁴

How can fibroids affect fertility?

Every woman’s experience is unique and she should talk with her doctor to understand the potential impact (if any) that her fibroids may have on her fertility. With that said, if you have a type of fibroid that is inside the uterine cavity – such as a submucosal fibroid – this could present complications while trying to get pregnant.² Fibroids can, in some cases, cause difficulty getting pregnant, because they can lead to a physical change in the uterus shape. For example, your fibroids could obstruct the shape of your uterus, and create a distortion of your endometrial cavity, or be in a tricky position and block access to your fallopian tubes.^5,6 For those who have fibroids that may be prohibiting conception, there are medical and surgical treatment options that may help. Minimally invasive procedures, such as hysteroscopic or laparoscopic myomectomy, which remove fibroids but not the uterus, are offered to women who desire future fertility. These procedures are the most common, and most successful, for fibroid treatment when considering fertility outcomes.⁵

How Can Fibroids Impact Pregnancy?

Many women with fibroids go on to have a successful, healthy pregnancy, but there are some possible complications to be aware of that should be discussed with your doctor. During pregnancy, fibroids may raise the risk of certain complications, such as placental abruption, fetal growth restriction, and preterm delivery.² Likewise, women with fibroids, specifically submucosal and intramural fibroids, may also have a slightly higher risk for miscarriage.⁵ Additionally, because fibroids tend to grow as a result of an increase in hormones, there is a chance your fibroids grow as the uterus expands during pregnancy.⁶

What can I do?

While it is important to be aware of the link between fibroids and fertility, it is equally so to know that there are many options to treat infertility issues and ensure a safe pregnancy. Finding the right medical team and feeling empowered to advocate for your own needs are key. If you are looking for a physician who specializes in fibroid treatment options that preserve fertility, visit our physician finder to find a local OBGYN: Physician Finder

Insufficient data exist on which to evaluate the safety and effectiveness of the Acessa® procedure in women who plan future pregnancy. Therefore, the Acessa procedure is not recommended for women who are planning future pregnancy.

References

1. Office on Women’s Health – Infertility – https://www.womenshealth.gov/a-z-topics/infertility
2. Mayo Clinic—Uterine Fibroids—mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
3. Baird DD, Dunson DB, Hill MV, Cousins D, Schechtman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003; 188:100—107.
4. Internal Analysis based on US Census population information total population women aged 15-64 (104 million women), Kaiser Family Foundation information for the number of Medicaid (25 million) and commercial lives (79 million), Wakely Actuarial Firm claims analysis for Fibroid ICD-10 diagnosis code prevalence in commercial claim data (6% of women in data set sought care for fibroid related diagnosis code) and internal assumption for Medicaid prevalence (6%).
5. Guo, X. C., & Segars, J. H. (2012). The impact and management of fibroids for fertility: an evidence-based approach. Obstetrics and gynecology clinics of North America, 39(4), 521–533. https://doi.org/10.1016/j.ogc.2012.09.005
6. Uterine Fibroid Fact Sheet. Office on Women’s Health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/a-z-topics/uterine-fibroids.
7. Cook H, Ezzati M, Segars J, et al. The impact of uterine leiomyomas on reproductive outcomes. Minerva Ginecol. 2010;62:225–36