Infertility From Fibroids

Did you know that many women carry extra growths of tissue called fibroids on and inside their uterus without even knowing about them? This may seem unnerving but these growths are mostly unnoticeable and many live long and happy lives without ever having any procedures done on them. But sometimes these growths can become a problem, not just to the woman who may experience discomfort, but also to the baby who wants to grow inside the uterus. This infertility from fibroid growths can be one of the reasons why you can’t have a child.

Fibroids or myomas are actually tumors. They are benign growths and rarely become cancerous (a study has shown that less than 1 out of a thousand cases of myoma are cancerous). They are fairly common, occurring in up to 50% of women in the prime of their reproductive capacity according to the American Society for Reproductive Medicine (ASRM). They are actually found in up to 80% of women past the age of reproduction. Though the actual causes of the growths are still largely unknown, evidence shows that they are genetic in nature. They occur more regularly in women who have relatives who had myoma and more regularly in African-American women.

Myomas are found in and around the uterus. With their high rate of incidence among women, they are mostly harmless. However, there are certain myomas that will cause problems. If a myoma becomes so large that it starts to change the shape of the uterus, pregnancy can be seriously affected. The baby needs a healthy uterus to survive and will have a difficult time developing if the uterus is malformed. Myomas have also been known to grow in places near the openings of the uterus that lead to other organs like the fallopian tubes. This will cause blockages that will prevent conception. But these cases remain rare however. In the almost 7.3 million American women who are reportedly infertile (from the National Survey of Family Growth, Centers for Disease Control and Prevention 2002), only 3% are caused by myoma alone.

Still, for the women who have myomas that interfere with fertility, treatment is very possible. Studies have shown that although myomas can reduce pregnancy rates in women by about 70%, correct treatment will return the woman’s chance of pregnancy back to the baseline level.

To determine whether or not your myomas are the cause of your infertility, an evaluation will be done on your uterus. This can be done through an ultrasound, a hysterosalpingogram, or a hysteroscopy. An ultra sound employs sound waves to get an image of your uterus. A hysterosalpingogram or HSG employs special contrast liquids to get an image. A hysteroscopy employs a hysteroscope which is a small camera that goes into your uterus to get an actual view of what is inside. Although myomas are usually easily detectable, it is important to ascertain their specific characteristics to determine proper treatment so you may have to go into multiple tests and evaluations.

If your myomas are determined to be affecting your fertility, they can be removed. This is usually done through surgery. For women past the age of reproduction, a hysterectomy is usually done but this involves removing the entire uterus along with the myomas. This is certainly not an option if you still want children so a myomectomy is preferred which specifically targets the myomas for removal. However, this is still a surgical procedure and you should discuss with your doctor the potential dangers and risks of going into such treatment. Be sure that you and your doctor know the exact nature of your myomas since the type and severity of the surgery will largely depend on the size, location, and type of your myomas. Some can actually be treated without incisions if they are removable through a hysteroscopic myectomy. A non-surgical approach is through Uterine Artery Embolization (UAE). This shrinks the myomas by cutting off the vessels that feed blood into it. However, as this process is relatively young being introduced in the 90s, not all after effects have been tabulated and studied. Myomectomy or UAE, either way, myomas are treatable and your chances of conceiving can be restored.