Fibroids and Fertility

Fibroids are a peculiar type of growth that develop in the uterus. They grow to different sizes and take on different shapes. Fibroids are not cancerous and they typically do not present any symptoms. However, if a person is pregnant and they have fibroids, the fibroids could cause medical complications.There are treatments available for fibroids, and most people are able to still become pregnant afterward.

What Are Fibroids?

Another way to refer to fibroids is ‘myomas’ or ‘leiomyomas’. One of the reasons they take on different shapes as they grow is because of the manner in which they develop. Further, their mode of development also determines their course of treatment. Let us look at different ways fibroids develop: 

• Intramural fibroids as hinted at by their name, usually develop inside the wall of the uterus.
• Submucosal fibroids tend to grow on a stalk, which stems from the wall of the uterus and extends into the uterus.
• Subserosal fibroids also grow on a stalk that stems from the uterine wall, but in this case, the stalk extends away from the uterus.

Signs of Fibroids

While fibroids do not generally present with symptoms, at times, a person may experience symptoms caused by their presence. These symptoms include: 

Menstruation Irregularities

When a person has fibroids, they may menstruate for a longer duration than usual, experience heavier bleeding than normal, frequent menstruation, or pain during heavy menstruation. 

Pain in the Pelvic Area or the Abdomen

Sometimes fibroids can grow particularly large, then they rupture. When this is the case, it could result in severe pain suddenly. During sex as well, a person may experience pain in their pelvic region or pressure. At times, this pain may be felt in their abdomen or lower back.

Interference of Bowel and Bladder Function

Fibroids that are located in the direction of the bowels or the bladder can at times grow large enough to interfere with regular bowel release. This results in difficulties urinating or passing stool, and at times, it can cause constipation, or frequent urination.   

Physical Changes

Fibroids sometimes grow so large that they distort the appearance of a person’s abdomen. At times this may look like an out-of-place protrusion or a pregnancy. 

Causes of Fibroids

While the trigger for fibroid growth is still not well understood, it has been discovered that estrogen feeds their growth. Females in their reproductive years are therefore more likely to develop fibroids. At times, fibroids have been linked to obesity, high blood pressure, lifestyle, genetics and a family history of fibroids.

Treatment of Fibroids

Both surgical and non-surgical interventions are used in the treatment of fibroids. Typically, professional healthcare providers will look into non-surgical options as the first line of treatment. 

Nonsurgical Options

Non-surgical treatments are usually applied to fibroids that are smaller in size or those that have mild symptoms. These are treated with either hormones or prescription medications.

Hormone-based Treatments

The active hormone in hormone-based treatments is gonadotropin-releasing hormone agonists (GnRHa). It lowers estrogen levels which in turn discourages the growth of fibroids, and relieves discomfort. As well, if a surgical intervention is required, this hormone-based treatment helps to reduce large fibroids, which facilitates the success of their removal.  GnRHa should not be used long-term.  

Medication-based Treatments

Contraceptive pills are the usual medication used to treat fibroids because they reduce the thickness of the uterine wall, which in turn controls excessive bleeding. This is particularly effective if the fibroids were causing heavy or excessive bleeding.

Uterine Fibroid Embolization

The blood supply to fibroids can be cut off in a procedure called embolization. This causes the fibroid to shrink and get damaged.  

Ultrasound-based Treatment

In this treatment, higher energy ultrasound waves are directed toward the fibroids, destroying them without damaging the surrounding tissue. 

Surgery

Surgical treatments are determined based on a patient’s age, health and family building plans. Let us see what these surgical interventions are and when they are used:

Hysteroscopic Myomectomy 

A hysteroscope is directed into the uterus through the cervix, after which a small surgical tool is used to burn away the fibroids. This treatment is usually done when a person has small fibroids, but they are problematic.

Laparoscopic Myomectomy

A laparoscopic surgery is done by first making small incisions around the surgical site. Thereafter surgical tools are inserted through these incisions and the surgery is conducted using a camera and screen to monitor the procedure. Usually this is done on fibroids that are a bit larger, but if they are too large to exit through the incision site, then open surgery would be the next option. 

Full Hysterectomy

A full hysterectomy is the removal of the uterus in its entirety. As earlier mentioned a person’s family building plans would be part of the considerations taken into account prior to any surgical procedure. This surgery is usually a last resort where the fibroids have become debilitating and the patient has no plans of becoming pregnant. If the patient however would like to build a family, they have an option of having their eggs retrieved prior to the hysterectomy.

If a person experiences fatigue, lightheadedness, weakness or severe vaginal bleeding, it could mean that they are experiencing fibroid related complications that are severe. Therefore emergency medical care must be sought immediately.

Summing It Up

Fibroids develop in different ways, take on different shapes and grow to different sizes. Fibroids are not harmful or cancerous, neither are they the cause of infertility in women. They typically do not cause symptoms and there are treatments available when they become problematic. However if you do have concerns about fibroids, fertility or family building, contact IVF Fertility Center for further assistance.