Every July, Fibroid Awareness Month brings a vital spotlight to an often-overlooked topic in women’s health: the link between fertility and fibroids. For millions of women, uterine fibroids disrupt daily life and complicate the dream of becoming a parent. Yet, with personalized care and advancements in reproductive medicine, hope is far from lost.
“Understanding fibroids isn’t just about symptom management; it’s about empowering women with knowledge so they can make informed choices about their reproductive health,” says Dr. Minoos Hosseinzadeh, Founder and Medical Director at Fertility Institute of San Diego.
What Are Uterine Fibroids?
Uterine fibroids are benign, non-cancerous tumors that grow within or around the uterus. These growths, also called leiomyomas or myomas, can vary in size from as small as a seed to larger than a grapefruit. Though they are common—affecting up to 70% of women by age 50—many remain asymptomatic.
How Fibroids Affect Reproductive Health
The connection between fertility and fibroids is nuanced. While not all fibroids impact conception or pregnancy, certain types can interfere with implantation, distort the uterine cavity, or lead to recurrent pregnancy loss.
“Fibroids located within the uterine cavity, known as submucosal fibroids, are particularly associated with decreased fertility,” explains Dr. Hosseinzadeh. “They can affect the endometrial lining, where an embryo would ideally implant.”
Symptoms of Fibroids
Many women with fibroids experience no symptoms. When symptoms do occur, they can include:
- Heavy or prolonged menstrual bleeding
- Pelvic pressure or pain
- Frequent urination
- Pain during intercourse
- Lower back pain
- Constipation
- Infertility or recurrent miscarriages
The severity and presence of symptoms often depend on the size, location, and number of fibroids.
Causes and Risk Factors
While the exact cause of fibroids remains uncertain, several risk factors have been identified:
- Genetics: Family history plays a significant role.
- Hormones: Estrogen and progesterone stimulate fibroid growth.
- Race: African American women are more likely to develop fibroids, and at a younger age.
- Diet: High red meat consumption and low intake of green vegetables may increase risk.
- Age: Most common in women aged 30–50.
Complications Linked to Fertility
Fibroids can:
- Block fallopian tubes
- Interfere with blood flow to the endometrium
- Disrupt embryo implantation
- Cause complications during pregnancy such as placental abruption or preterm labor
“It’s not just about whether fibroids are present,” notes Dr. Hosseinzadeh, “but where they are and how they interact with the uterine environment. That’s why individualized assessment is key.”
Diagnosis: When and How
Diagnosing fibroids typically involves pelvic exams and imaging tests:
- Transvaginal ultrasound
- MRI scans for detailed mapping
- Hysterosonography (saline infusion sonogram)
- Hysteroscopy for visual evaluation of the uterine cavity
Early diagnosis allows for timely management, especially when fertility preservation is a concern.
Fibroid Management and Treatment Options
Treatment depends on a woman’s symptoms, reproductive goals, and fibroid characteristics. Options include:
1. Medical Management
- Hormonal therapies (GnRH agonists, progestins)
- Non-hormonal options (tranexamic acid for bleeding control)
2. Surgical Options
- Myomectomy: Surgical removal of fibroids, ideal for women wishing to preserve fertility
- Hysterectomy: Complete removal of the uterus, used in severe cases or when fertility is no longer desired
- Hysteroscopic resection: Minimally invasive removal of submucosal fibroids
3. Minimally Invasive Procedures
- Uterine Fibroid Embolization (UFE): Blocks blood supply to fibroids; not always recommended for women seeking pregnancy
- Radiofrequency ablation: Uses heat to shrink fibroids; still under research for fertility impact
Prevention and Lifestyle Considerations
Though fibroids can’t always be prevented, certain lifestyle changes may reduce risk:
- Maintaining a healthy weight
- Eating a balanced diet rich in leafy greens and low in red meat
- Regular pelvic exams for early diagnosis
- Regular physical activity
The Cost of Treatment
Fibroid treatment costs vary depending on the method, insurance coverage, and healthcare setting. While myomectomy and embolization can range from $5,000 to $12,000, many fertility-focused procedures may be covered under reproductive health benefits or fertility preservation plans.
At Fertility Institute of San Diego, our concierge-style approach ensures that patients receive personalized financial counseling to navigate insurance and out-of-pocket costs.
When to See a Specialist
If you’re experiencing fibroid symptoms or struggling to conceive, it’s crucial to seek expert guidance.
“Women often delay seeking help, thinking their symptoms are ‘normal’,” says Dr. Hosseinzadeh. “If your quality of life is affected or you’re trying to start a family, don’t wait. Early intervention can make all the difference.”
FAQs
Are fibroids cancerous?
No, fibroids are benign. Less than 1% may become cancerous (a condition called leiomyosarcoma), but this is extremely rare.
Can fibroids go away on their own?
Some fibroids shrink after menopause due to lower estrogen levels. However, others may require treatment if symptomatic.
Is pregnancy possible with fibroids?
Yes, many women with fibroids conceive and carry healthy pregnancies. Fertility outcomes improve with proper management.
How do I know if fibroids are affecting my fertility?
Consult a fertility specialist. Imaging and diagnostic tools can determine if fibroids are interfering with conception.
What is the most fertility-preserving treatment?
Myomectomy is the gold standard for removing fibroids while preserving the uterus and future pregnancy potential.
Take the Next Step
If you’re ready to start your fertility journey, please book a complimentary virtual consultation with Dr. Hosseinzadeh to go over fertility options or any other reproductive healthcare questions. Click here to schedule.