Fibroids and Fertility

Basic Facts of Fertility


The number of eggs you have affects the chances of getting pregnant. Egg numbers decrease as women age, and unfortunately you do not create new eggs


A woman’s age is an important factor in getting pregnant. Egg quality is determined by age and decreases with advancing age. After the age of 35, fertility decreases drastically.


Are your Fallopian tubes open? Scar tissue and compression of the tubes can cause blockages in your tubes, which is often assessed by performing an HSG (hysterosalpingogram is an x-ray dye test that allows your provider to see your uterus and fallopian tubes).


Uterus structure: Factors include uterine anomalies, fibroids, adenomyosis and other conditions can affect fertility.


Other factors: A male partners sperm, other hormone conditions can affect fertility (PCOS, etc) and finally rare genetic disorders

Impact of Fibroids on Fertility:

Now let’s understand how fibroids have an impact on fertility:

1. Fibroid location:

Location of fibroids with in the uterus affects fertility. The closer your fibroid is to the inner lining of your uterus, the higher the risk of infertility. Intracavity (pedunculated submucosal), submucosal and intramural fibroids are known to adversely affect fertility.

2. Fibroid Size

The size of your fibroids affects fertility. Statistically, a fibroid that is larger than 4 cm can cause issues with your fertility and interfere with your ability to carry a pregnancy to term.

3. Fibroid Numbers:

The number of fibroids play a role in infertility with a larger count typically causing more issues.

4. Normal Gene Expression

Some studies state that just having fibroids can negatively affect the normal gene expression, which is critical for embryo implantation. Fibroids impact the entire endometrium, not only the part that is in direct contact with the fibroid.

Fibroid Treatment and Fertility:

Fertility is often at the forefront during discussions of fibroid treatment options with your OBGYNs and primary care providers. If you are of childbearing age and plan on becoming pregnant you may be subject to the same narrative – invasive surgery is the only viable solution to cure your fibroids.

Treatment of fibroids include myomectomy (surgery cutting out fibroid(s)) and UFE (non-surgical shrinking of fibroids).

Studies have shown, however, that a solution that ends in myomectomy is far from a cure for fibroids. In fact, its impact on your fertility might be contrary to what you desire.

Comparing Research Studies

Below are some RECENT studies citing pregnancy rates OR live birth rates after treating fibroids via myomectomy or UFE:

In Summary:

While extensive research has not been conducted to conclusively decide in favor of one versus the other fibroid treatment option and its impact on female fertility, it is important to consider several factors that play a key role in affecting your fertility.

The greater number of fibroids you have, the harder it is to get pregnant.  The older you are, the harder it is to get pregnant.  The closer the fibroid is to the inner lining, the harder it can be to get pregnant.  Finally, the larger the fibroid is, the harder it is to get pregnant

To determine which treatment option will impact your fertility the most, it is vital to determine the size, location and number of fibroids that are afflicting you through MRI. MRI studies are far more accurate study of your uterus than a pelvic ultrasound, which is why all patients seen at Atlanta Fibroid Clinic receive an MRI study.

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