It has always been an interesting phenomenon that some women get pregnant by just looking at their husbands, and other women struggle with conceiving. The CDC website reports that one in five women between the ages of 15 and 49 have issues becoming pregnant after trying for a year. Another surprising statistic is that a fourth of the women in this age group either have trouble conceiving or sustaining a pregnancy. Over 25% of women in their childbearing years face challenges trying to have a baby, which is a huge number.
Overcoming infertility can be tricky because it is often hard to determine what the underlying issues are. Both men and women can have issues that result in infertility, but it is easier to identify issues that surround male infertility. A woman has to have the perfect trifecta of a uterus, ovaries, and fallopian tubes that are all in good health and functioning properly for conception to even be possible.
Women’s reproductive system is complex, and if any of these necessary organs are not at their best, it can prevent conception or result in a miscarriage. Some conditions that can negatively affect one or more of these three key organs include:
- PCOS (polycystic ovary syndrome) is where a woman does not ovulate on a regular basis, and her levels of testosterone can be out of balance, causing acne or unusual hair growth;
- Hypothalamic amenorrhea (FHA) can occur if a woman exercises too much, is too stressed out, has a low enough BMI to be considered unhealthy, or sometimes a combination of these;
- DOR (diminished ovarian reserve) is a condition where a woman has fewer eggs than she should at a given age;
- Pituitary gland or hypothalamus issues can prevent a woman from ovulating;
- Premature menopause;
- Blocked fallopian tubes;
- Irregular uterine issues such as adhesions, polyps, endometriosis, adenomyosis, and fibroids.
Today we are going to talk about one of these issues: uterine fibroids, or myomas. Even though they only make up between 5% and 10% of women’s fertility issues, according to the ASRM (American Society for Reproductive Medicine), many women are not aware that fibroids can prevent them from conceiving or carrying a pregnancy to term.
A Bit About These Benign Growths
To understand how a fibroid can inhibit pregnancy, let’s review a bit about them. Myomas are tumors that grow in and on the uterus, and no one really knows what causes them to show up. Research has shown that some women are more predisposed to having them because of their ethnicity, family history, lifestyle, and health, but there is no known way to prevent them from forming.
Since they can develop in different locations within the uterus, they can affect a woman’s menstrual flow and cause uncomfortable or even severe symptoms. There can be one growing alone, or there can be many growing in clusters, and they can range in size from a small grain of rice to the size of a medium pumpkin.
When Can Fibroids Cause Conception Issues?
We are often asked, “What size fibroid can prevent pregnancy“? It may surprise you to learn that while big fibroids can present challenges with conception, it is more about where these growths are located on or in the uterus.
Intramural fibroids grow within the muscular walls of the uterus and can distort their shape, poke through the lining, and intrude into the embryo’s personal space. Even if these are not large-sized fibroids, they can prevent pregnancy, cause a miscarriage, or cause major complications during pregnancy. Submucosal fibroids grow in or on the uterus lining and can also hinder successful conception.
Myomas can grow in groups, which can cause the same issues as a single large tumor. They can cause the uterus to be misshapen, create inflammation, irregular blood vessel patterns, or create unwanted uterine contractions that can result in complications like preterm labor or spontaneous abortion.
For about 2%-3% of women, these growths are the only reason they are experiencing fertility issues, and in other cases, they can exacerbate other underlying conditions. A study published in 2021 reported that women with fibroids had substantially fewer instances of implantation, pregnancy, and live birth than those without the tumors. The other notable finding was that women with myomas had a significantly higher rate of spontaneous abortion.
What Is The Typical Size Of A Fibroid That Inhibits Conception?
Large fibroids can prevent conception or a viable pregnancy, but clusters of smaller fibroids can also create issues. Most experts agree that growths reaching around 5cm in diameter (a little smaller than 2 inches) should be removed from the uterus. For a woman who wants to preserve her fertility, removing her uterus through a hysterectomy is not a viable option.
Typically, an OB/GYN would recommend some form of myomectomy surgery, but this may or may not solve her infertility problem. If she has growths embedded deep in her uterine walls, the surgeon most likely will not be able to successfully remove the entire thing. Many times, when they do manage to get them out, the uterus ends up looking like a piece of Swiss cheese and is left weaker and compromised. After a myomectomy, many doctors will not allow their patients to proceed with vaginal births and mandatory C-sections must be performed.
What Should You Do If You Want A Baby But Have Fibroids?
If you have fibroids and you wish to become pregnant, getting a handle on these growths before you try to conceive would be the best strategy. An MRI imaging test can reveal the exact size and location of your growths and can indicate whether the size of the fibroid(s) will prevent a pregnancy from being viable or your chances at successful conception.
The specialists at the Atlanta Fibroid Center have over 40 years of combined experience in treating these unwanted growths and can help eliminate them without surgery. Your doctor may not tell you about this non-surgical procedure because only a highly skilled interventional radiologist who has been expertly trained can perform it. Uterine fibroid embolization (UFE) eliminates fibroids without compromising your uterus and also preserves your fertility. (We have an entire wall of baby pictures provided by our patients who have become pregnant after UFE).
Even if you are not experiencing other fibroid symptoms, they could be preventing you from becoming pregnant. Make an appointment today to see one of our specialists and find out if UFE can help you.