Womens Health

Fibroids and Infertility - A Connection?

Fibroids are usually non-cancerous tumors that grow in the pelvis.  They are very common, and approximately 75% of women who have fibroids live with them without ever having them removed or having problems with them.  For the other 25%, however, the fibroids can certainly pose fertility problems and other issues in women.

Who Is Most At Risk For Fibroids?

Women are most likely to develop fibroids in their 30s and 40s, a time when they are most likely to want to conceive.  Traditionally, fibroids that were very large or that were a problem were removed with a hysterectomy, but this is a surgery that removes the uterus and makes it impossible for a woman to conceive.  Obviously, this surgery is becoming less acceptable to women who still want to conceive, and other options are arising as the medical profession learns more about fibroids.

What Risk Factors Are Connected To Fibroids?

There are a number of risk factors that increase your chances of having fibroids.  Women who have had one or more pregnancies that went beyond the fifth month have less risk.  In general, birth control pills help to reduce the risk of developing fibroids, but researchers think that people who use the pill between the ages of 13 and 16 may have an increased risk. Smoking decreases the risk of fibroids and large quantities of red meat seems to increase the risk. Finally, African American women seem to have a much higher rate of fibroids, although researchers are not sure why this is the case.

Fibroids and Fertility

There are a number of reasons that fibroids may cause infertility.  A fibroid can be pushing on the fallopian tubes, creating a blockage that does not allow sperm to get to the egg, or that does not allow release of the egg.  Some fibroids may make it difficult for the egg to implant properly and for the embryo to grow and develop.  Many of these same difficulties can lead to miscarriage.  

Treatment for Fibroids

There are many tests that can be done to determine if a woman has fibroids, and if the fibroids are interfering with her chances of fertility.  They are sometimes found during a pelvic exam, and can usually be detected through ultrasound.  Most times when a woman has fibroids, she will not need treatment and will not have a difficulty with fertility due to the fibroid.  However, should the fibroid be quite large, or should it create a problem with fertility, there are a number of treatment options.  There are a number of surgeries that can be preformed to remove the fibroids, while keeping the uterus in tact. This is obviously the preferred course of treatment for a woman in childbearing years.  During an abdominal myomectomy, an incision is made in the abdomen and the fibroids are removed.  With a laparoscopic myomectomy, the fibroids are removed through laparoscopy.  A hysteroscopic myomectomy involves using a fiberoptic telescope through the vagina and cervix to remove the fibroids in the uterus.   Serious complications are usually uncommon with any of these procedures.  Between 11 and 26% of women who have myomectomy will need a second surgery.  In addition, both abdominal and laparoscopic myomectomy have a degree of risk for uterine rupture during pregnancy or labor.  Sometimes, doctors will recommend that a woman have a Cesarean delivery after having this surgery.

At the moment, these are the best options for women of childbearing years who have been inhibited by a fibroid.  Doctors are trying to test certain drugs at the moment, hoping to create less invasive treatments for fibroids.  It is certainly important to know about these problems and to consult with a doctor should you think that you have a fertility issue due to fibroids.

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