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Polyps or Fibroids in the Uterus: Do They Impair Fertility?

Polyps or Fibroids in the Uterus: Do They Impair Fertility?

December 7, 2020

Uterine fibroids and uterine polyps are both very prevalent abnormal benign growths in the uterus. Although different in nature, they can cause similar symptoms and often contribute to female infertility. Today we are going to look at the polyps and fibroids in the uterus from the fertility point of view and see what can be done to improve it.

We are starting with a basic comparison that will help you understand the similarities and differences between uterine fibroids and endometrial polyps. Then, we will look at the way fibroids and polyps might prevent pregnancy. In the end, we will learn about the solutions available to treat these conditions and increase the chances to conceive a baby.

What Are Polyps and Fibroids in the Uterus?

FibroidsPolyps
What are other names for them?Uterine fibroids, leiomyomas, myomasUterine polyps, endometrial polyps
What are they?Benign tumors in or outside of the uterusAbnormal growths of the uterine lining, the endometrium
How do they look like?Round or oval in shape, sometimes on a stalkRound or oval in shape, sometimes on a stalk
Where are they located?Inside the uterus, on the uterus or within the uterus muscle wallInside the uterine cavity
How big are they?From a few mm to a melon sizeFrom a few mm to a few cm
Are they hard or soft?Hard like a rockSoft
How many can I have?Single or multipleSingle or multiple
Are they painful?No, but they might cause unpleasant symptomsNo, but they might cause unpleasant symptoms
Can they lead to cancer?Extremely rarelyRarely
How often are they cancerous?Less than 0.1%Less than 5%

Fibroids and polyps are not life-threatening but might cause severe symptoms reducing the quality of the patient’s life in general, and particularly reducing chances to conceive, carry or deliver a baby.

Related: Uterine Fibroids Vs. Ovarian Cysts.

Fibroids vs. Polyps: Similar Symptoms of Very Different Conditions

FibroidsPolyps
Can they be asymptomatic?Yes, in ~50% of casesYes, in ~65% of cases
What are the primary symptoms?
  • heavy menstrual bleeding
  • intermenstrual bleeding
  • bleeding after intercourse
  • bleeding after menopause
Can they cause anemia?YesYes
Can they cause infertility?Yes, in 5-10% of casesYes, in 15-25% of cases
Who is at risk?
  • women of reproductive age
  • women with a family history of fibroids
  • African-American women
  • obese women
  • women with high estrogen consumption (foods or medications)
  • women of reproductive age
  • pre-, peri-menopausal women
  • obese women
  • women receiving hormonal therapy
How are they diagnosed?Physical examination, ultrasound, or MRISaline sonohysterography (a special ultrasound study) most commonly, ultrasound or MRI
Can they disappear?Yes, after menopause fibroids can shrinkYes, polyps can disappear on their own
Can they be treated?Yes, surgically and non-surgicallyYes, non-surgical hysteroscopic removal

Can Polyp or Fibroid in the Uterus Impair Fertility?

There is a number of known reasons for female infertility. In some cases, only one factor impacts the ability to conceive; in other cases, a combination of factors causes fertility issues. Therefore, it’s important to consider all possible conditions, including polyps or fibroids.

Read our in-depth article on fertility and infertility with fibroids.

Fibroids and polyps found in the uterus can affect a woman’s fertility. Their size and location should be considered first when evaluating a female for fertility status and planning treatment if needed. Uterine fibroids contribute to infertility in 5 to 10% of cases. As for endometrial polyps, the percentage of infertile women having them reaches 15 to 25%.

Here is how these uterine growths can affect fertility:

  1. Fibroids growing inside the uterine cavity (submucosal fibroids) and polyps might act as natural intrauterine devices (IUDs) physically preventing implantation of a fertilized egg.
  2. Same growths might block the cervix, and sperm won’t reach an egg to fertilize it.
  3. If fallopian tubes are blocked, sperm won’t meet an egg or a fertilized egg won’t enter the cavity to attach to the uterine wall and start a pregnancy.
  4. Large-size rock-hard fibroids of any type might alter the uterus’ shape affecting the traveling of sperm and implantation.

The presence of polyps or fibroids in the uterus does not necessarily make a woman infertile. However, they might cause complications during pregnancy, such as a miscarriage, placental abruption or cesarean delivery. Therefore, a woman with fibroids or polyps should consult a specialist to understand her options.

Video: How Does UFE Work?

Can Uterine Fibroid Embolization Treat Infertility?

When the main cause of infertility is identified, choosing an appropriate treatment is the next vital step. In the case of uterine fibroids, uterine fibroid embolization (UFE) can be considered as a safer and effective solution to treat the symptoms caused by fibroids in women who are still interested in future fertility. The procedure works by blocking the blood supply to uterine fibroids until they are dead. The UFE procedure is non-surgical and doesn’t require a hospital stay. Since the procedure is non-surgical and outpatient, the recovery is much faster compared to surgical treatments, and the risks of surgery are avoided, too.

Patients with uterine fibroids who underwent UFE can conceive naturally and deliver a full-term baby naturally unlike women who opted for myomectomy (a fibroid surgery) will require a C-section. More information about the UFE procedure, fibroids, and fertility is available on ATLii.com. If you’re suffering from fibroids, get a consultation from one of the nation’s leading fibroid experts, Dr. John Lipman of Atlanta Fibroid Center. To make an appointment, please call 770-953-2600, or go to ATLii.com.