Fibroids And Pregnancy
When diagnosed with uterine fibroids, many women of childbearing age are concerned about the effect of the disease on their chances to conceive and carry a baby. Many women are not informed by their OB/GYN of all the options currently available to them for treating fibroids. Typically OB/GYNs will only discuss treatments that they perform such as myomectomy or hysterectomy surgery.
Many women ask “Can I get pregnant with fibroids?”, “Do fibroids affect fertility?” and “Is having fibroids dangerous during pregnancy?” Today we are going to answer some of the questions surrounding fibroids and pregnancy.
Can I Have A Baby with Fibroids?
If you are wondering if you can have a successful pregnancy with fibroids you are not alone. Fibroids can affect women in different ways depending on how many fibroids they have, the location of the fibroids, and their size.
Some women who have fibroids never even know they have them because they show no symptoms while other women suffer from painful life-interrupting issues.
Many women with fibroids conceive, have uneventful pregnancies, and deliver healthy full-term babies while others have difficulty conceiving or experience fibroid-related complications during their pregnancy.
Can Fibroids Affect Conception?
Fibroids can affect a woman’s ability to become pregnant in a few different ways. Some of the factors that play a part in fibroids and fertility include:
- Their location;
- Their size;
- The number of fibroids present.
Submucosal fibroids are the most likely to inhibit conception because they grow inside the uterine cavity. These fibroids can decrease a woman’s fertility rate by 70%. Submucosal fibroids can prevent pregnancy by distorting the shape of the uterus enough that the embryo is unable to implant and become viable.
If a submucosal fibroid reaches a large size it can exert enough pressure on the fallopian tube to squeeze it closed, preventing fertilization by blocking the pathway of sperm to the egg. Similarly, a fertilized egg may be blocked on its route through the fallopian tube back to the uterus.
Fibroids and Pregnancy: Miscarriage Risks
The question of whether fibroids can cause a miscarriage has been under debate for a few years. Some studies indicate that women who have fibroids are more likely to suffer a miscarriage than women without fibroids as well as studies report that the risks of miscarriage are the same for both groups of women; those with fibroids and those without.
That being said, not all fibroids are the same, in size, number, or location. As submucosal and intramural fibroids grow, they can take up room that a growing fetus would need, preventing proper growth and development and leading to miscarriage. Additionally, fibroids need a blood supply to grow and they eventually can divert the blood flow away from the growing baby.
Another concerning issue with having submucosal fibroids when pregnant is that studies have shown that fibroids can grow quite large, and grow rapidly, during the first trimester of pregnancy. This is because of the increase in blood flow to the uterus and hormone surges that occur during the first 12 weeks of pregnancy.
Large Fibroids And Pregnancy
One condition that is noteworthy when dealing with fibroids during pregnancy is to be vigilant in watching for signs of a potentially serious condition called necrobiosis and occurs in 2% to 28% of pregnant women with fibroids.
Necrobiosis is caused when fibroids that have grown large during the first several months of pregnancy begin to degenerate causing severe pain in the abdomen, abnormal bleeding, nausea, or high body temperature.
Childbirth and Fibroids
Many women with fibroids have no complications during pregnancy or childbirth. However, of the 20% – 30% that do, about 5% of these women experience fibroid-related pregnancy issues that are serious.
Women with large fibroids are more at risk for breech birth, premature rupture of membranes, preterm labor, placental abruption, placenta previa, babies with low birth weight, and can have complications during labor that requires a cesarean delivery or C-section. Depending on the size and position of certain fibroids they can affect the position of the baby or even block the birth canal and prevent a vaginal delivery.
Postpartum Complications From Fibroids
One of the most serious complications a woman can experience after giving birth is severe postpartum hemorrhage. This is a condition that occurs when a woman loses too much blood after giving birth and women who deliver by C-section are more at risk.
Large fibroids during pregnancy can distort the uterus and interfere with its functionality. After a woman gives birth, the uterus goes through a series of contractions that help it to return to its smaller size. Fibroids may inhibit that function resulting in a large loss of blood and postpartum hemorrhage.
How To Deal With Fibroids During Pregnancy
Most women who have uterine fibroids and get pregnant do not experience serious complications but they may have some temporary discomfort during their first or second trimester. If you have fibroids or a history of fibroids, it is important that you let your doctor know so they can monitor your pregnancy, watch for potential complications and address any discomfort you may experience.
When a woman becomes pregnant, her body increases the production of hormones which subsequently has an effect on any fibroids that are present during pregnancy. Fibroids thrive and can grow large in an estrogen-rich environment coupled with the normal increase in blood flow that occurs during pregnancy.
Large fibroids can make these pregnancy symptoms worse:
- Abdominal pain & cramps;
- Digestive issues;
- Frequent urination.
Usually, by the fourth month, these hormone surges have leveled out, and the fibroids that may have grown larger since the onset of pregnancy may begin to shrink. This is not always the case and these large fibroids may continue to interfere and cause complications throughout the pregnancy.
Should I Treat Fibroids Before Getting Pregnant?
Ideally, yes. If you are diagnosed with fibroids before you become pregnant and your doctor feels that they could interfere with your fertility or the safety of a developing fetus, it would be prudent to eliminate them sooner rather than later.
Work closely with your doctor to determine the treatment that is right for you. Ask questions, do your research, and do not be afraid to seek out a second opinion.
Among the various treatments for fibroids, Uterine fibroid embolization (UFE) is a non-surgical procedure that eliminates all existing fibroids by cutting off their blood supply. This 45-minute outpatient procedure is safer than surgery and has only a week of recovery time vs the four to six-week recovery associated with surgery.
Dr. John Lipman and Dr. Mitchell Ermentrout from The Atlanta Fibroid Center have been helping women become free from fibroids for a combined total of over 40 years. The Atlanta Fibroid Center has an entire wall showcasing the dozens of women who became mothers after having UFE.
Many of these women could not get pregnant or had numerous miscarriages before UFE. 3-6 months after the procedure, they became pregnant and subsequently gave birth to healthy babies.
This entire wall with letters from happy mothers and photos of their children is a confirmation that uterine fibroid embolization is a safe, permanent, and reliable method of treating uterine fibroids for women who have fibroids and dream of becoming a mother.
To learn more about pregnancy and fibroids, and see if UFE might be right for you, call Atlanta Fibroid Center at 770-214-4600 or make an appointment online.