Can You Get Pregnant With Uterine Fibroids

Can I Get Pregnant With Submucosal Fibroids

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Fibroids are non-cancerous tumors found in the uterus. Many women of child-bearing age have fibroids. About 40% of caucasian women have them by the age of 35, while about 60% of women of African or Afro-Carribean descent have them.Many are able to easily become pregnant with fibroids. However, they can sometimes make it more difficult to conceive.

Submucosal fibroids are a certain type that appear under the inner lining of the uterus. They can affect the lining of your uterus and reduce your fertility.

Fibroids can sometimes go away on their own, but thats usually after menopause. For women trying to get pregnant, fibroids could be just one factor affecting her ability to conceive.

Some doctors recommend using fertility medication to help the fibroids shrink. Gonadotrophin-releasing hormone analogues , for example, help reduce estrogen levels and temporarily halt fibroid growth. Lupin Depot and Syranel spray are common GnRH IVF medications.

Other doctors may recommend surgical procedures to remove them, but there are a range of mild treatments available for fibroids. Getting pregnant medications are one of the less invasive options.

Can Uterine Fibroids Harm My Pregnancy

Early in pregnancy, it’s not uncommon to diagnose a patient with preexisting conditions that might cause concern during the next nine months.

While diabetes and high blood pressure are common concerns we diagnose during pregnancy, 1% to 10% of expectant moms are found to have uterine fibroids abnormal but noncancerous tissue growths inside the uterus during a prenatal ultrasound. For some this is a new finding, but many women are already aware they have them.

Uterine fibroids are common. By age 35, 40% to 60% of women will have developed these growths, which can cause abdominal bulkiness and heavy or painful periods.

Even so, the diagnosis can be alarming for some patients. I have weird tissue growing near my baby? What does that mean for my pregnancy?

While there is a large amount of research on fibroids in nonpregnant patients, data are limited on how fibroids can affect pregnancy. Thankfully, we do know that most patients with fibroids will have an uneventful pregnancy and delivery.

Having a few small fibroids is rarely cause for concern. However, depending on the location of your fibroids, how many you have, and whether they are large fibroids can range from the size of a coin to a basketball we will monitor for certain situations that can cause problems during pregnancy.

Can I Still Get Pregnant If I Have Uterine Fibroids

Uterine fibroids, also called leiomyomas or myomas, are noncancerous growths in or on the uterus that often appear during a womans childbearing years. They arent associated with an increased risk of uterine cancer, and they rarely develop into any form of cancer.

Fibroids range in size from tiny spots invisible to the human eye to bulky masses that enlarge and distort the uterus. You can have one fibroid or many. Many women develop fibroids at some point, but they might not know it because there often arent symptoms, especially if theyre small.

Usually your doctor discovers them during a pelvic exam or a prenatal ultrasound.

Hany H Ahmed, MD, is an experienced, board-certified OB/GYN in Houston, Texas, who provides comprehensive womens health services and specializes in normal and high-risk pregnancy care.

He gets asked a lot about uterine fibroids and if they interfere with getting pregnant and carrying a baby to term. So he put together this guide on the topic. Heres what you need to know.

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Are You Trying To Get Pregnant With Fibroids

One of the symptoms of uterine fibroids is infertility so this is something to be aware of if you are trying to get pregnant with fibroids. But the good news is that many women with fibroids can still get pregnant and deliver a healthy baby when the time comes. Some dont even know that they have fibroids until their checkups during the pregnancy.

But fibroids do pose various problems so it is best before you get pregnant that you have no fibroids because even if they are small, the increased hormone activity during the pregnancy may cause them to grow at a rapid rate which means these tumors will compete for space in the uterus with your baby which is not ideal. Some may even need to be removed during the pregnancy with surgery but who wants to have surgery when they are pregnant?

If My Best Chance For A Successful Pregnancy Is Fibroid Treatment What Are The Options

Can I Get Pregnant With Fibroids

Removing fibroids to improve the chance for conception and pregnancy may be recommended to you. Often, a doctor will suggest a surgery called myomectomy. Myomectomy cuts out existing fibroids. While this form of fibroid removal is fairly common, it has several drawbacks.

  • Surgery to the uterus may cause scarring. Uterine scarring can make the successful implantation of an embryo problematic.
  • If any part, even a few cells, of a fibroid are left behind, that fibroid will have a 50% chance of regrowth within a period of about 10 months. This makes your window of opportunity for conception and pregnancy very limited.
  • If you have a myomectomy and dont get pregnant fairly quickly, you could wind up facing multiple surgeries as fibroids repeatedly grow back.
  • Surgery to the uterine walls can also weaken them. Sometimes, this compromises carrying a baby to term and/or its delivery.

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Can I Still Get Pregnant

About 20-80% of women develop fibroids by the age of 50, with 30% of these women developing fibroids between the ages of 25-44. This means that a large number of women are diagnosed with fibroids during childbearing years. Most of the time, uterine fibroids do not interfere with a womans ability to get pregnant. But in 10-30% of cases, some women will experience fertility challenges or pregnancy complications.

Treating Fibroids Before Pregnancy

Uterine fibroids are most common during the reproductive years, so it comes as no surprise to us that many of our patients are concerned about preserving fertility. Some avoid treatment altogether because theyve been told a hysterectomy, the complete surgical removal of the uterus, is their only option. We want you to know that this isnt true.

At USA Fibroid Centers, our experts offer an effective, non-surgical treatment that can preserve your uterus and retain your fertility. Uterine Fibroid Embolization is a minimally invasive, outpatient procedure that involves less risk and a significantly shorter recovery time than fibroid surgery.

If you suffer from symptomatic fibroids and have not been able to conceive, we suggest inquiring whether you are a good candidate for UFE. Even if you do not want to undergo uterine fibroid treatment during pregnancy, conceiving may become easier if you treat your fibroids prior to conception.

Treating fibroids before pregnancy is the safer, better alternative. Monitor any symptoms of uterine fibroids you may experience and seek medical advice as soon as possible. If you wait to seek treatment for fibroids until after you discover that youre pregnant, your treatment options will be limited until the baby is born. Due to the risk for the baby, doctors will generally only prescribe bed rest, mild pain relievers, and hydration to deal with the symptoms.

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What Causes Fibroids To Grow

While medical research is yet to pinpoint the exact factors that cause fibroids to grow, they have been seen to grow when the reproductive hormone levels estrogen and progesterone are high.

This usually happens during pregnancy, when the levels of both estrogen and progesterone rise rapidly. Anti-hormone medications have been observed to shrink the size of fibroids, and so has the onset of menopause.

Second And Third Trimesters

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As your uterus expands to make room for your baby, it can push against your fibroids. This can cause a number of issues during your pregnancy:

  • Pain. This is the most common symptom of fibroids, especially if theyâre large. Sometimes, fibroids twist, which can cause cramping and discomfort. Other times, the fibroid outgrows its blood supply, turns red and dies. This process, called âred degeneration,â can cause severe stomach pains. In some cases, it can lead to miscarriage. Over-the-counter medicines like acetaminophen can ease your pain. But avoid ibuprofen early in your pregnancy because it may cause problems with gestation and also in your third trimester. It could cause you to miscarry, reduce the amount of amniotic fluid or cause hearts problems in your baby.
  • Placental abruption. Ongoing studies seem to show that pregnant women with fibroids have a much greater chance of placental abruption than women without fibroids. That means your placenta tears away from the wall of your uterus before your baby is delivered. Itâs very serious because your baby wonât get enough oxygen and you can have heavy bleeding. You could go into shock.
  • Preterm delivery. If you have fibroids, youâre more likely to deliver preterm — meaning your baby is born before 37 weeks of pregnancy — than women without fibroids.

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Uterine Fibroids And Pregnancy Complications

Fibroids generally develop before pregnancy. In many cases women remain unaware of the presence of the tumor until they get an ultrasound done.

  • You can also detect the tumor with a pelvic exam. Also, watch out for the above mentioned symptoms.
  • When you know about your fibroids beforehand, you can ask your doctor about the probable complications in your pregnancy.
  • These are non-cancerous developments that generally do not interfere with your pregnancy.
  • Around 30% of the women face complications in pregnancy such as abdominal pains along with vaginal bleeding.
  • Unless your bleeding is substantial, your baby will be rarely affected.
  • Submucosal fibroids directly affect the ability to conceive as they distort the entire uterus, thereby disturbing the implantation of the embryo even after fertilization.
  • The sooner you try to conceive, the lesser are the chances of infertility due to fibroids or even the occurrence of the fibroids.
  • If your doctor feels that the presence of a fibroid is affecting your plans to conceive, he or she may recommend you to try conceiving for up to two more years.
  • If you are over 34, chances of conceiving become lower. This is the instance where your doctor will recommend treating the fibroid through any of the above options except UAE.

Finding The Right Treatment

The vast majority of fertility issues are not due to fibroids. But if you suspect fibroids are impacting your ability to have children, you and your partner should be thoroughly evaluated. Start by ruling out that other issues arent the actual cause. If your doctor feels that fibroids are preventing you from getting pregnant, its time to seek treatment.

Remember, its always advisable to consider fibroid treatment before considering pregnancy. Fibroids often grow along with the baby, creating further problems. The best chance for a safe and uneventful pregnancy is to deal with any obstacles before youve conceived.

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How Fibroids Affect Pregnancy

Fibroids are common. Most of the time, they dont affect your ability to get pregnant. But if you have a lot of fibroids or theyre submucosal fibroids, they may affect fertility.

Having fibroids doesnt interfere with ovulation, but submucosal fibroids can make it harder for your uterus to support conception and maintain pregnancy. In some cases, this type of fibroid can cause infertility or pregnancy loss.

Dr. Coppa diagnoses fibroids with a pelvic exam that might include an ultrasound or MRI. Depending on the size and location of your fibroids, he recommends a treatment plan thats right for you. If youre pregnant or trying to conceive, its important to monitor the fibroids closely.

Having fibroids while pregnant can increase your risk of complications during labor and delivery, including the likelihood that youll need a cesarean section. Your risk of placental abruption or preterm delivery might also be higher if you have fibroids.

Whether youre trying to get pregnant and are concerned about your fertility or youre pregnant and have fibroids, Dr. Coppa is here to help you have a healthy, full-term baby. the location closest to you or request an appointment online today to learn more.

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What To Consider Before Getting Pregnant If You Have Fibroids

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Since fibroids may cause complications for both you and the baby during pregnancy, you may want to consider having treatment before getting pregnant. Additionally, fibroids are associated in 10% of infertility cases and are the sole cause of infertility in up to 3% of patients.

Many women believe that hysterectomy, the surgical removal of the uterus, is the only treatment available for fibroids. Although hysterectomy is the treatment most often recommended and performed for fibroids, we want you to know there are other options.

If you have fibroids and are considering getting pregnant, our fibroid specialists can help. They can provide an accurate diagnosis of the size and location of your fibroids using ultrasound guidance.

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Complications That Fibroids Cause Within A Pregnancy

Though it is possible for a woman with fibroids to become pregnant, it is more difficult in many cases. If your fibroids alter the shape of your uterus, they can bring challenges. Both natural and in-vitro fertilization pregnancies can prove far more difficult. The reduction in fertility rates is up to 70%. Especially challenging are:

  • Intramural fibroids

Left untreated, fibroids can lead to:

  • Premature birth
  • Heavy bleeding after giving birth

What Are The Effects Of Fibroids On Fertility

Many women who have fibroids can get pregnant naturally. Treatment may not even be necessary for conception.

In some cases, however, fibroids can impact your fertility. For example, submucosal fibroids, which are a type of fibroid that grows and bulges into the uterine cavity, increase your risk for infertility or pregnancy loss.

While fibroids may cause infertility for some women, other explanations for infertility are more common. If youre having trouble conceiving or maintaining a pregnancy, your doctor may explore other possible causes before attributing the issue to fibroids.

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Effect Of Myomectomy On Art Outcome

As discussed previously, evidence suggests that fibroid size prior to ART can cause lower implantation rates. In patients with intramural fibroids > 50 mm, myomectomy before IVF has been shown to positively impact pregnancy outcomes . A study by Bulletti et al. in 2004 compared 84 women who chose to undergo myomectomy before IVF with 84 women who started IVF but did not undergo surgery. The women who did undergo surgery had a 25% rate of delivery and a clinical pregnancy rate of 33%, compared to 12% and 15% in the nonsurgical group . This study suggested that myomectomy before ART is likely to improve pregnancy outcomes in infertile patients with submucosal fibroids, and with intramural fibroids > 5 cm . For subserosal fibroids, myomectomy before ART does not affect pregnancy outcomes.

Pregnancy Rates And Obstetrical Outcomes Following Uae

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UAE is not recommended for women with fibroids who desire future fertility, in part due to reported cases of transient and permanent amenorrhea. The reduction in menstrual flow raises the concern for endometrial damage that may contribute to abnormal placentation and/or reduced ovarian function or failure. However, the incidence of amenorrhea has been found to occur in less than 5% of patients and is clearly exacerbated by advanced age or perimenopausal status.

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What Size Fibroids Should Be Removed

Larger fibroids are associated with lower chances of getting pregnant and carrying a full-term pregnancy, but the jurys still out on what size fibroids should be removed.

Whether fibroids should be removed before pregnancy depends on many factors, including location, size, and number of fibroids, as well as your past and current health history.

Effect Of Fibroids On Art

The relationship between fibroids and infertility has been elucidated through numerous studies on ART patients, which have been summarized in several meta-analyses and systematic reviews . Although abnormal gamete transfer and blockage of fallopian tubes are circumvented by assisted reproductive technologies , fibroids may also compromise fertility by altering the endometrial receptivity thus negatively affecting embryo implantation and lowering the chances for pregnancy.

Fibroid location is of critical importance in ART outcomes . Submucosal fibroids, in particular, significantly reduce implantation and pregnancy rates of ART. Submucosal fibroids that distort the uterine cavity have been found to carry a relative risk of 0.3 for pregnancy and 0.28 for implantation after ART, when compared to infertile women without fibroids. Other authors have also demonstrated reduced success following ART with an odds ratio of 0.3 for conception and 0.3 for delivery in the presence of submucosal fibroids . The effect is not as pronounced for intramural fibroids with an odds ratio of 0.62 for implantation rate, and 0.7 for delivery rate per transfer cycle . Similarly, Somigliana et al. determined an odds ratio of 0.8 for conception and 0.7 for delivery with intramural fibroids. Subserosal fibroids have negligible impact on fertility with ART .

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Can Fibroids Affect My Pregnancy

Its a good idea to keep an eye on fibroids during pregnancy because they may grow larger and create complications. Only 2-12% of pregnant women have fibroids and if they do grow, it will most likely be during the first 12 weeks. For more information about how fibroids may affect your pregnancy and here. Fibroids affect many women, often at an age when they are trying to get pregnant. Research shows that the rate at which fibroids alone cause infertility is quite low and most often related to submucosal fibroids.

If you think you have fibroids, you should see your doctor for a diagnosis and, if found, have an assessment of their size, number and location. If you have fibroids and you and your partner are having problems getting pregnant, you should both have a fertility work-up to look at all possible causes including fibroids. Whether it is worth seeking treatment for fibroids before other treatments such as in vitro fertilization depends on your unique situation. Your doctor can help you evaluate the options that are best for you.

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