Fibroids and Pregnancy -What to Know

Uterine fibroids are noncancerous growths that can develop on, inside, or attached to the uterus. These growths can arise due to various factors, including aging, genetics, and hormonal imbalances. While some women with fibroids may not experience noticeable symptoms, many others suffer from significant discomfort and various adverse effects caused by these fibroids.

In particular, fibroids can have a significant impact on pregnancy. Even without prior fibroid treatments, some women may develop fibroids during pregnancy, leading to symptoms such as preterm birth and miscarriage. This connection between fibroids and pregnancy highlights the importance of understanding and managing this condition for women's reproductive health.

What Are Fibroids?

Fibroids are benign tumors that can attach themselves to both inside and outside of the uterus, sometimes connected by a stalk known as the peduncle. Fibroids are composed of muscle cells and connective tissue, that range in size from small nodules to large masses. Around 20% to 80% of women develop fibroids by the time they reach the age of 50.

While many women who suffer from uterine fibroids do not have symptoms, others may endure issues such as heavy menstrual bleeding, abdominal pain, heaviness, inflammation, cramping, and frequent urination. The exact causes of these symptoms are still under study, but current research suggests that fibroids are generally linked to factors like age, genetics, and hormonal imbalances.

Fibroids and Infertility

Among the 20% of reproductive-aged women with fibroids, approximately 5% to 10% will struggle with infertility. Most fertility issues associated with fibroids stem from their presence within the uterus, hindering the possibility of a healthy pregnancy and childbirth.

Intramural and submucosal fibroids are most likely to be linked to infertility problems. Intramural fibroids are growths that attach themselves to the inner wall of the uterus. In contrast, submucosal fibroids develop beneath the lining of the uterus. Although the latter of these is one of the least common types of fibroid, it causes the most pain and heaviest periods, significantly impacting the ability to conceive.

Fibroids can also contribute to fertility problems when they develop within the fallopian tubes, alter the shape of the cervix and uterus, or affect the thickness of the uterine lining. Notably, research has shown that the removal and treatment of fibroids can result in a 23% increase in the likelihood of achieving pregnancy.

Fibroids and Pregnancy

Infertility is not the only pregnancy-related struggle that fibroids can cause. Even if a woman is able to get pregnant with fibroids there may be adverse health implications. Although it's relatively uncommon for fibroids to develop or be present during pregnancy, it's not unheard of.

Challenges of fibroid pregnancy include bleeding, pain, and miscarriage during the first trimester. In the second and third trimesters, there's also a possibility of placental detachment from the uterine wall, known as placenta abruption, The result is severe pain which is caused by the fibroids twisting and may lead to preterm birth. Women with fibroids are more likely to undergo C-sections and experience breech births, which can introduce additional medical complexities for both the mother and the baby.

Does Pregnancy Cause Fibroids?

Fortunately, pregnancy does not lead to the development of any new uterine fibroids but existing fibroids can continue to grow. Many fibroids are driven by elevated levels of the hormone estrogen, and during pregnancy, estrogen levels naturally rise. One study found that one-third of fibroids can increase in size during the first trimester. However, another study also proved some women can experience a shrinkage of fibroids they already have instead.

Pregnancy-Safe Fibroid Treatments

Fibroids can pose health challenges for women during pregnancy, but there are solutions to help solve that. However, individuals who are pregnant or hoping to become pregnant may want to avoid specific treatments. For example, a hysterectomy removes fibroids and stops future ones from developing by removing the uterus. However, this procedure also renders future pregnancies impossible, making it unsuitable for those desiring to have children in the future.

Endometrial ablation may be a good procedure to consider for those looking to improve their fertility before pregnancy. Endometrial ablation is a nonsurgical procedure that removes the lining of the uterus with heat energy to end heavy menstrual bleeding. During pregnancy, this treatment is generally avoided to ensure the safety of the baby. Instead, common approaches include bed rest, hydration, and pain relief medication.

There are other safe treatment options available for fibroids during pregnancy as well. Myomectomy is a surgical procedure that removes fibroids while preserving the uterus, making it a viable choice for some cases. Myolysis is another option, involving the shrinking of the blood vessels that supply the fibroids.

As a reminder, it is always best to consult your doctor or schedule a fibroid consultation if you think you may have fibroids. A medical provider will address the health effects of fibroid removal, answer your questions, and discuss how long you should wait before trying to become pregnant.

Dealing with fibroids can be a distressing and challenging journey, but there is hope for relief. Effective treatments are available to enhance fertility, alleviate pain, and promote a more relaxed pregnancy for expectant mothers.