Fibroids and Fertility: How Uterine Fibroids Affect Your Ability to Conceive

Learn how uterine fibroids can affect conception and what Viva Eve's Fibroid 360 program can do to help.

Trying to Conceive Dr. James A. Gohar MD, FACOG 8 min read
Couple holding hands while discussing fertility and family planning

TL;DR

Most fibroids do not stand in the way of pregnancy. Certain fibroids that grow into the uterine cavity can affect implantation, but this is something that can be carefully evaluated and addressed. Viva Eve’s Fibroid 360 program takes the time to assess your specific fibroids and develop a personalized plan designed to support your reproductive health and goals.

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Important

Contact your doctor immediately if you experience heavy bleeding, severe pelvic pain, or difficulty urinating during your TTC journey.

In This Article

What Are Uterine Fibroids?

Uterine fibroids (leiomyomas) are benign growths of the uterus and are extremely common, affecting up to 80% of women by age 50. They most often occur during the reproductive years.

Uterine fibroids develop from the smooth muscle layer of the uterus, known as the myometrium. They are almost always benign (noncancerous), but their size, number, and location can significantly influence symptoms and reproductive health. Some women have a single fibroid, while others may have many, ranging in size from a tiny seed to larger than a grapefruit. Fibroids are commonly categorized based on where they grow in the uterus: intramural fibroids lie within the uterine wall, subserosal fibroids grow on the outer surface of the uterus, and submucosal fibroids extend into the uterine cavity. Understanding the type and location of fibroids is an important first step in assessing how they may affect fertility and guiding treatment decisions.

Can Fibroids Cause Infertility?

While most women with fibroids can get pregnant naturally, certain types of fibroids—particularly submucosal ones—can interfere with fertility by blocking the fallopian tubes or preventing embryo implantation.

In order for it to grow and develop, it is necessary for an embryo to implant itself in the uterine lining. If the blood flow is compromised due to a fibroid, it can present problems in this process.The impact of fibroids on your fertility depends heavily on where they are located. Submucosal fibroids, which grow just under the uterine lining and bulge into the cavity, are the most likely to cause issues. They can change the shape of the uterus or affect the quality of the lining, making it harder for a fertilized egg to attach. Intramural fibroids may also affect fertility if they are large (typically over 4 cm) or if they distort the uterine cavity. Subserosal fibroids generally do not affect your ability to conceive, though they can cause other symptoms like pelvic pressure or frequent urination.
Our Fibroid 360 program evaluates every fibroid by type, size, and location to determine its specific impact on your fertility. We use advanced 3D ultrasound and saline-infused sonograms (SIS) to map your uterus with precision.

How Do Fibroids Affect Pregnancy and Miscarriage Risk?

Fibroids can increase the risk of certain pregnancy complications, including miscarriage, preterm birth, and breech presentation, especially if they grow significantly during the first trimester.

During pregnancy, hormonal changes can sometimes affect fibroids as well. In most cases, this does not cause problems, though some women may notice temporary discomfort as their body adapts. While certain fibroid patterns may be associated with a slightly higher risk of pregnancy complications, the majority of women with fibroids go on to have healthy, full‑term pregnancies. With attentive care and close monitoring from Viva Eve’s expert OB/GYN team, any potential concerns can be identified early and managed thoughtfully to support both you and your baby.

What Are the Symptoms of Fibroids During TTC?

Common symptoms of fibroids that may arise while you are trying to conceive (TTC) include heavy menstrual bleeding, pelvic pain, and pressure on the bladder or rectum.

Many women don't realize they have fibroids until they start tracking their cycles or experience difficulty conceiving. You should pay close attention to your periods; if they are lasting longer than seven days or are exceptionally heavy (soaking through a pad every hour), fibroids may be the cause. Pelvic pain (dysmenorrhea) can also be a significant indicator. This pain might occur during your period or during intercourse (dyspareunia). If you're experiencing these symptoms, it's important to discuss them with your Viva Eve provider during your preconception checkup.

How Are Fibroids Diagnosed at Viva Eve?

We diagnose fibroids using a combination of pelvic exams, high-resolution ultrasound, and minimally invasive procedures like hysteroscopy or MRI when necessary.

At our Forest Hills and Midtown East locations, we offer on-site diagnostics so you can get answers quickly. Most fibroids are first detected during a routine pelvic exam where your doctor might feel an irregularly shaped uterus. To confirm the diagnosis and determine the exact location, we perform a transvaginal ultrasound. If we suspect the fibroids are inside the uterine cavity, we may recommend a saline-infused sonogram (SIS) or a diagnostic hysteroscopy, where a small camera is used to look inside the uterus.

What Are the Treatment Options for Fertility-Focused Patients?

For women wishing to preserve fertility, myomectomy (surgical removal of fibroids while keeping the uterus intact) is often the gold standard of treatment.

At Viva Eve, we specialize in minimally invasive myomectomy techniques. Depending on the size and location of your fibroids, this can be done hysteroscopically (through the cervix, leaving no scars) or laparoscopically. While we are leaders in Uterine Fibroid Embolization (UFE), we typically don't recommend UFE for women who are actively trying to conceive or plan to in the future, as its impact on future pregnancy is still being studied. Our team will work with you to choose the safest path that preserves your uterine health.
Understanding the location of your fibroids is crucial for fertility planning.

Frequently Asked Questions

Find quick answers to common questions about how uterine fibroids (leiomyomas) impact your fertility and pregnancy journey.

Common Questions

Frequently Asked Questions

Most women with fibroids are able to conceive naturally. In some cases, fibroids can affect implantation, depending largely on their size and where they are located within the uterus.

Fibroids can increase the risk of miscarriage, particularly in the first and second trimesters. This risk is highest when fibroids distort the uterine cavity or interfere with the blood supply to the developing placenta.

About one-third of fibroids grow during the first trimester due to increased hormone levels. However, many fibroids stay the same size or even shrink after the baby is born. Regular monitoring via ultrasound is recommended.

Yes, a procedure called a myomectomy is specifically designed to remove fibroids while leaving the uterus intact. This is the preferred surgical option for women who wish to preserve their fertility.

Most doctors recommend waiting three to six months after a myomectomy before trying to conceive. This allows the uterine wall to heal completely, ensuring it is strong enough to support a growing pregnancy.

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