Uterine fibroids are the most common benign tumors affecting the female reproductive system, impacting a significant number of women during their reproductive years. In India, estimates suggest that by age 50, nearly 70% of women may develop these growths, though many remain undiagnosed due to a lack of symptoms.
For women planning a family, the diagnosis of fibroids often brings anxiety regarding fertility and pregnancy outcomes. Understanding the relationship between these growths and reproductive health is essential for making informed decisions. At SGVP Holistic Hospital in Ahmedabad, our Department of Obstetrics & Gynaecology (Matrutva) specializes in diagnosing and managing these conditions to preserve fertility and restore quality of life.
Do Fibroids Cause Infertility?
Yes, certain types of fibroids can lead to infertility by blocking the fallopian tubes or preventing embryo implantation. However, not all fibroids affect fertility; it largely depends on their size and location. Treatments like laparoscopic myomectomy can effectively remove these growths while preserving the uterus, significantly improving the chances of natural conception.
What Are Uterine Fibroids?
Uterine fibroids, also known as leiomyomas, are non-cancerous muscular growths that develop in or around the uterus. They can range in size from tiny seedlings to bulky masses that distort the uterine shape.
Doctors categorise them based on their location, which is the key factor in how they impact fertility:
- Submucosal Fibroids: Grow inside the uterine cavity and are most likely to cause heavy bleeding and infertility by interfering with implantation.
- Intramural Fibroids: Grow within the muscular wall of the uterus. Large ones can distort the uterine cavity and affect pregnancy.
- Subserosal Fibroids: Grow on the outer wall of the uterus. These rarely affect fertility unless they become large enough to compress nearby organs, such as the fallopian tubes.
Who Needs Evaluation?
Many women with fibroids have no symptoms, but for others, the signs can be disruptive. You should seek an evaluation at a specialised centre if you experience:
- Heavy or Prolonged Periods: Menstrual bleeding that lasts longer than a week or requires frequent pad changes.
- Pelvic Pain or Pressure: A constant feeling of heaviness or sharp pain in the lower abdomen.
- Frequent Urination: Large fibroids can press against the bladder, causing a constant urge to urinate.
- Difficulty Conceiving: Inability to get pregnant after 6–12 months of trying.
- Pain During Intercourse: Deep pain during sex (dyspareunia) can be a sign of fibroids or endometriosis.
Causes and Risk Factors
While the exact cause is unknown, several factors increase the likelihood of developing fibroids:
- Hormonal Influence: Estrogen and progesterone stimulate the growth of fibroids, which is why they often shrink after menopause.
- Age: They are most common in women in their 30s and 40s.
- Family History: Having a mother or sister with fibroids increases your risk.
- Lifestyle: Obesity and a diet high in red meat are linked to a higher risk, whereas a diet rich in green vegetables may be protective.
- Early Menstruation: Starting periods at a young age (before 10) extends the hormonal exposure of the uterus.
Treatment Procedure Explained
At SGVP Holistic Hospital, we adopt world-class treatment procedures. Whenever possible, we use approaches which cause the least harm to the uterus, especially for women wishing to conceive.
- Advanced Diagnosis: The process begins with a Transvaginal Ultrasound or MRI to map the exact number, size, and location of the fibroids.
- Medical Management: For small, asymptomatic fibroids, doctors may prescribe hormonal medications to manage heavy menstrual bleeding and monitor the growth of the fibroids.
- Laparoscopic Myomectomy: This is the gold standard for fertility preservation. Surgeons use small incisions to remove only the fibroids while leaving the healthy uterine tissue intact.
- Hysteroscopic Myomectomy: For fibroids inside the uterine cavity (submucosal), a camera is inserted through the vagina to remove them without any external cuts. This offers the fastest recovery.
Checklist: Preparing for Your Consultation
A visit to a gynaecologist can be stressful. Use this checklist to ensure you get the most out of your appointment at SGVP Holistic Hospital:
- Symptom Diary: Track your menstrual cycle, bleeding intensity, and pain levels for at least two months before the visit.
- Family History: Note down if any female relatives have had fibroids, endometriosis, or fertility issues.
- Fertility Goals: Clearly state if you plan to have children in the near or distant future, as this dictates the treatment plan.
- Previous Tests: Bring any past ultrasound reports or blood test results.
- Current Medications: Please list all supplements and hormonal medications you are currently taking.
Recovery, Risks, and Outcomes
- Recovery Timeline: Most patients undergoing laparoscopic myomectomy are discharged within 24–48 hours and return to normal activities within 2 weeks.
- Fertility Outlook: Studies have shown a significant improvement in pregnancy rates following the removal of submucosal and intramural fibroids.
- Risks: While rare, risks include mild blood loss or infection. In very complex cases, there is a small risk that a hysterectomy (removal of the uterus) might be required if bleeding cannot be controlled, though this is a last resort.
- Holistic Care: Following surgery, patients are guided on making diet and lifestyle changes to prevent recurrence.
Expert Validation
Dr Rinky Agrawal, a Consultant Obstetrician and Gynaecologist at SGVP Holistic Hospital, emphasises that not every fibroid requires surgery. Our goal is to identify which specific fibroids are hindering fertility and treat them with precision while leaving the healthy uterus untouched for future pregnancies. With extensive experience in high-risk obstetrics and infertility, Dr Agrawal advocates for a personalised approach combining modern surgical techniques with holistic wellness.
Frequently Asked Questions (FAQs)
Fibroids typically do not disappear on their own during reproductive years. However, they often shrink after menopause due to the drop in estrogen levels.
Yes, many women with fibroids have healthy pregnancies. However, depending on their size and location, they can increase the risk of miscarriage, preterm delivery, or the need for a C-section.
Myomectomy (surgical removal of fibroids) is the preferred treatment for women seeking pregnancy. Unlike a hysterectomy, it preserves the uterus. Procedures like uterine artery embolisation are generally not recommended for those planning to conceive.
Regular pelvic exams and ultrasounds are the only reliable methods for tracking growth. Increasing symptoms like heavier bleeding or more pelvic pressure are often signs that fibroids are enlarging.
When to See a Doctor
If you experience sharp, sudden pelvic pain, or if your periods become so heavy that they interfere with your daily life (causing anaemia or fatigue), immediate consultation is necessary. For those trying to conceive, an evaluation is recommended after 6 months of unsuccessful attempts.
