Author: Dr Antoine Abu Musa (Fertility Consultant & Chief Medical Officer, NOW-fertility)
Fibroids are benign tumours of the uterus and are the most common gynaecological abnormality. They can lead to problems like heavy menstrual bleeding, pelvic pain, sexual dysfunction, pressure discomfort, and infertility. The connection between fibroids and fertility has been a topic of discussion for many years. While many women with fibroids don’t experience infertility, it’s generally agreed that fibroids located closer to the uterine cavity and the endometrium lining can have a negative impact on fertility, reducing the chances of successful pregnancy.
Fibroids can affect infertility by different mechanisms. It has been suggested that fibroids can cause symptoms like pelvic pain, painful intercourse, and heavy menstrual bleeding, which can disrupt sexual arousal and reduce the likelihood of conception. In addition, fibroids might interfere with the transportation of eggs and sperm by affecting the uterine muscle’s contractions or by physically pressing on the fallopian tubes or altering the uterine cavity. Furthermore, fibroids could create an unfavorable environment for embryo implantation. They may cause inflammatory changes in the endometrium, and alter blood supply to it.
Thorough assessments of fibroids, including their number, size, location, and blood supply, should be a routine part of evaluating women who want to become pregnant or who are experiencing infertility. This will help in proper counselling of the patients and designing the best treatment approach.
In conclusion, while not all individuals with fibroids experience infertility, there’s growing evidence suggesting a potential negative impact. Still, the relationship between infertility and fibroids requires further research. Understanding how fibroids influence fertility is crucial for developing treatments that specifically target fibroids while considering the desire to become pregnant.
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