Can Uterine Fibroids affect Fertility?

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Having uterine fibroids, Singapore guide

If I have uterine fibroids, can I still get pregnant? Will it affect my pregnancy? Will I have difficulties during childbirth? Should I get uterine fibroid embolisation (UFE, Singapore) or other fibroids treatment? Singapore Vascular and Interventional Centre is here for you. In this article we will explain how uterine fibroids can affect your ability to conceive and even cause problems during pregnancy and delivery.

There are a few different types of uterine fibroids, and some of these fibroids will have a greater and more significant effect than others on fertility and pregnancy. Check out this article [All you need to know about Uterine Fibroids] to find out more about the different types of uterine fibroids and their recommended treatment.

WHAT IS FERTILITY?

Fertility refers to the ability of a woman to become pregnant, carry a pregnancy and ultimately give birth. In women, fertility depends on the successful passage of sperm through the vagina, the uterus and to the fallopian tube; the implantation of a fertilised egg in the endometrium (wall) of the uterus, and the ability of the uterus to support the healthy development of a baby. Uterine fibroids can affect each of these factors and stages, thus reducing the fertility of a woman.

HOW DO UTERINE FIBROIDS AFFECT FERTILITY/PREGNANCY?

  • Narrowing Fertile Window

A common symptom of uterine fibroids is menorrhagia, which is heavy and longer bleeding during monthly periods. This shortens the fertile time for sex, making it harder for a woman to conceive.

  • Physical barrier to fertilisation & implantation

Submucosal (partially in the uterine cavity), intracavitary (completely in the uterine cavity), and pedunculated (on a stalk) uterine fibroids may obstruct the passage of sperm from the vagina to the fallopian tube. Because the sperm are blocked from meeting the egg, the chances of fertilisation decreases. Even if fertilisation can occur, the uterine fibroids make it harder for the zygote (fertilised egg) to implant into the wall of the uterus.

  • Distortion of the shape of female reproductive organs

Subserosal fibroids (outside of the uterine cavity) could cause external compression of the fallopian tube or the ovary affecting the passage of sperm or egg along the reproductive tract and thus adversely affecting fertility.

  • Pain/Red degeneration

Uterine fibroids can cause significant pain during the second and third trimesters of a pregnancy. This occurs especially with large fibroids which may outgrow their blood supply. The fibroid tissue then starts to die leading to a process known as “red degeneration”. In some instances, it can also lead to miscarriage.

  • Placental Abruption

Placental Abruption refers to when the placenta tears away from the endometrium before the baby has fully developed. This deprives the baby of sufficient oxygen leading to miscarriage. It can also lead to heavy bleeding thus putting the life of both the mother and child at risk.

  • Increase risk of miscarriage/preterm delivery

Studies have shown that women with uterine fibroids are more likely to have a miscarriage, with the chance of miscarriage being 14% as compared to 7.5% in women who do not have fibroids. Women with uterine fibroids are also more likely to deliver preterm (i.e. baby is born before 37 weeks of pregnancy) which can affect the health of the baby.

  • Change position of baby (breech birth)

Because uterine fibroids take up space in the uterus, the shape of the uterine cavity would be altered, which means that the positioning of the baby may end up being abnormal. Sometimes, there is less amniotic fluid for the baby to move in, which prevents the baby from getting into the headfirst position for delivery, which can then cause a difficult breech birth (feet or bottom first delivery).

  • Obstruction of delivery

Submucosal and intracavitary fibroids can narrow the cervical passage causing obstruction to the birth canal and making delivery much harder. Uterine fibroids may also prevent the walls of the uterus from contracting properly, making normal vaginal delivery difficult. Studies have shown that women with uterine fibroids are unfortunately 6 times more likely to need a C-section (Caesarean section) for delivery than women without uterine fibroids.

There are a few different types of uterine fibroids, with the submucosal type having the highest impact on fertility followed by the intramural type. Small (<5cm) fibroids and the subserosal type of fibroids are less likely to affect fertility and likely do not need to be treated prior to getting pregnant.

HOW CAN I IMPROVE MY FERTILITY IF I HAVE UTERINE FIBROIDS?

Singapore women often have this question, and our friendly surgeons are here to help. They will be able to make a comprehensive assessment of the type of uterine fibroids affecting you and the risk they pose to your fertility. They will also be able to advise if treatment of your uterine fibroids is likely to be beneficial to improve your chances of conceiving, and of having a pain free and safe pregnancy and delivery.

Uterine fibroids can also cause pain and discomfort during the usual menstrual cycle, thus if you are concerned about your fertility or you are having symptoms related to uterine fibroids, do consider getting them removed.

There are now many minimally invasive, simple treatments available such as uterine fibroid embolisation (UFE, Singapore) for the treatment of uterine fibroids which are safer and allow for faster recovery. Feel free to book an appointment or visit our website to find out more about how you can receive appropriate fibroids treatment. Singapore Vascular and Interventional Centre is here to help so do contact us today!

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