Impact of Uterine Fibroids on Fertility: What You Need to Know

Uterine fibroids

Hello, Dr.
Huang.
In February of this year, I experienced heavy menstrual bleeding (having to change sanitary pads every 1-2 hours), a significant amount of blood clots, noticeable pain during the first three days, and a prolonged menstrual period lasting about 10 days.
Since then, while the menstrual flow has decreased somewhat compared to February, it is still noticeably heavier than before, with ongoing pain and blood clots.
I still need to take pain medication during the first 2-3 days, and my menstrual periods continue to last around 10 days.
In October, I underwent a transvaginal ultrasound, and the doctor indicated that there is a submucosal fibroid measuring approximately 3x2 cm in the uterine cavity.
I would like to ask if this will affect my chances of conceiving in the future.
Should I just continue with regular monitoring? Thank you, doctor.

IYEH, 20~29 year old female. Ask Date: 2018/11/01

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In February of this year, my menstrual period was unusually heavy (requiring a change of sanitary pads every 1-2 hours), with a significant amount of blood clots.
I experienced noticeable cramps during the first three days, and the duration of my period was long (10 days).
After that, although the flow was somewhat less than in February, it was still noticeably increased compared to my normal pattern, with persistent pain and blood clots.
For the first 2-3 days, I still needed to take pain relief medication, and my periods continued to last around 10 days.
In October, I underwent a transvaginal ultrasound, and the doctor indicated that there is a submucosal fibroid measuring approximately 3x2 cm in the uterine cavity.
I would like to ask the doctor: 1.
Will this affect my chances of conceiving in the future? Answer: Whether it will affect future fertility can only be determined after marriage.
2.
Should I just continue with regular monitoring for now? Answer: Yes.

Reply Date: 2018/11/01

More Info

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the muscular wall of the uterus. They are quite common, especially in women of reproductive age, and can vary in size, number, and location. Your concerns regarding the impact of these fibroids on fertility are valid, and it's essential to understand how they may affect your ability to conceive.

1. Impact on Fertility: The presence of fibroids can influence fertility in several ways, depending on their size, location, and number. Submucosal fibroids, which grow just beneath the uterine lining, are particularly concerning as they can distort the uterine cavity, potentially interfering with implantation of an embryo. Intramural fibroids, which grow within the uterine wall, can also affect fertility, especially if they are large. However, many women with fibroids can conceive and have healthy pregnancies.

2. Symptoms and Monitoring: The symptoms you describe—heavy menstrual bleeding, prolonged periods, and significant pain—are common with fibroids. These symptoms can sometimes indicate that the fibroids are affecting your quality of life and may warrant treatment. Regular monitoring is crucial, especially if your symptoms worsen or if you plan to conceive soon. Your healthcare provider may recommend periodic ultrasounds to track the size and number of fibroids.

3. Treatment Options: If you are planning to conceive and your fibroids are not significantly impacting your fertility, your doctor may suggest a watchful waiting approach. However, if the fibroids are large or causing severe symptoms, treatment options such as medication to manage symptoms or surgical options like myomectomy (removal of fibroids) may be considered. Surgical intervention can improve your chances of conception, especially if the fibroids are obstructing the uterine cavity.

4. Pregnancy Considerations: If you do conceive with fibroids, it's essential to have a care plan in place. While many women with fibroids have successful pregnancies, there can be risks such as preterm labor, placental abruption, or complications during delivery, depending on the fibroid's size and location. Regular prenatal care is vital to monitor any changes in your fibroids during pregnancy.

5. Consultation with a Specialist: Given your symptoms and the presence of a submucosal fibroid, it may be beneficial to consult with a fertility specialist or a gynecologist who has experience in managing fibroids and fertility issues. They can provide personalized advice based on your specific situation and help you weigh the risks and benefits of potential treatments.

In summary, while uterine fibroids can impact fertility, many women with fibroids can still conceive and have healthy pregnancies. Regular monitoring and open communication with your healthcare provider are essential as you navigate your fertility journey. If your symptoms persist or worsen, discussing treatment options may be necessary to optimize your chances of conception.

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