Fibroids and Infertility

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Fibroids – masses in or around the uterus - may cause infertility. If the fibroids change the shape of the uterus, or are inside it, they can decrease fertility by about 70%, and when they’re removed, they increase fertility by 70%. If a fibroid is inside the wall of the uterus but doesn’t change its shape, or if it’s outside the wall, it won’t impact fertility, and when it’s removed, it won’t improve fertility.

Studies have indicated that women with fibroids who have no other apparent cause to be infertile may benefit fertility-wise from the removal of their fibroids. One study examined 94 infertile women with fibroids who had at least one tumor measuring more than 3 centimeters. After these fibroids were removed, 59.5% of the women conceived successfully, most of them within a short period of time. Another study concluded that only certain types of fibroids needed to be removed to improve fertility: these included fibroids that changed the shape of the uterus; fibroids bigger than 3cm; and tumors that blocked the fallopian tubes.

Fibroids can also cause miscarriages, sometimes repeatedly. It’s about 40% likely that a woman with fibroids will have a miscarriage. If the fibroid protrudes into the uterus, or if it’s completely within the uterus, it can thin out the uterine lining and make it inflamed. This makes it hard for an egg to implant and develop, and may result in a miscarriage. After the masses are removed, 80% of women with fibroids who suffer miscarriages will be able to get pregnant and carry to term.

It’s also possible, however, that the egg may implant in a spot within the uterus that’s not close to the fibroid, and develop properly without miscarrying. However, if the doctor finds a fibroid within the uterus, it’s a good idea to have it removed, just in case it impacts a growing pregnancy.

When fibroids are removed, it’s especially important for the surgeon to reconstruct the uterus properly, so that it doesn’t impact fertility. The uterine wall can be left with irregular spots after myomectomy, or surgical fibroid removal. The surgeon must repair these spots, so they don’t bleed or become infected. If the uterus isn’t repaired well, it can rupture during pregnancy or childbirth. An improperly reconstructed uterine wall can also lead to internal bleeding, pelvic adhesions (in which other tissue becomes stuck to the uterus), damage or blockage of the fallopian tubes, and chronic pelvic pain, all of which can end up making a woman infertile.


 
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