Fibroids and Fertility

Fibroids are a type of growth found in the uterus that takes on different shapes and sizes as it grows. They are not cancerous and neither are they harmful. They also do not present with any symptoms, but sometimes their presence can result in medical complications for example in pregnancy. Fibroids can be treated once they are detected, and in a majority of cases, patients are able to still have children thereafter. 

What Are Fibroids?

Fibroids are also known as myomas or leiomyomas, and they develop in different ways within the uterus. The way in which they develop determines the course of treatment to manage them. Below is a description of various types of fibroids:

• Intramural fibroids - These develop within the wall of the uterus.
• Submucosal fibroids -This type of fibroids grows on a stalk stemming from the uterine wall and extending into the uterus.
• Subserosal fibroids - This type also grows on a stalk stemming from the uterine wall, but instead, extending away from the uterus

The submucosal and subserosal fibroids are also referred to as pedunculated, due to the stalk on which they develop upon. 

Signs of Fibroids

Fibroids do not always present with symptoms, in fact, many times a person with fibroids may not even be aware of the fact. On occasion, they do present with symptoms such as: 

Menstruation Irregularities

Some of the menstrual irregularities that could emerge as a result of fibroids are menstruating for longer than usual, having heavy bleeding during menstruation, pain accompanying heavy menstruation, and frequent menstruation.

Pain in the Pelvic Area or the Abdomen

Sometimes, a fibroid could ‘suddenly die’, and if it was large at the time, this could result in sudden severe pain. At times, during sexual intercourse, fibroids may cause a person to experience strong pressure, or pain in their pelvic area. Again, the pain may be experienced in their lower back, or abdomen.

Interference of Bowel and Bladder Function

Fibroids can also interfere with regular rhythm of a person’s bowels or bladder because of where they are located. When they cause interference, a person may experience constipation, difficulty passing stool or urinating, as well as causing a person to urinate frequently.   

Physical Changes

On occasion, fibroids can grow so large as to distort a person’s normal appearance. In such cases, a person will appear to have a protrusion that is out of place. At times, they may appear to be pregnant even though they are not. 

Causes of Fibroids

What causes fibroids to develop is not known, but the presence of estrogen can cause them to grow rapidly.  This means that females are likely to develop them, particularly in their reproductive years. Other causes have been linked to lifestyle and genetics, obesity and high blood pressure, as well as family history.

Treatment of Fibroids

As stated earlier, fibroids can be treated using both surgical and non-surgical approaches. The non-surgical approach is typically the first line of action unless the fibroids are too big or numerous. Let us look at the various ways of treating fibroids next.

Nonsurgical Options

The non-surgical options are used to treat small fibroids, or fibroids that present with milder symptoms. The options include prescription medicine or hormones.

Hormone-based Treatments

Hormone-based treatments use gonadotropin-releasing hormone agonists (GnRHa) which reduces the levels of estrogen in the body. Since fibroids thrive on the production of estrogen, they begin to shrink or stop developing, and this in turn alleviates the discomfort they were causing. This treatment is also used as a pre-surgical protocol where fibroids are large, and facilitates their removal with better success. GnRHa however is not formulated for long-term use.  

Medication-based Treatments

Medicine-based treatments are typically in the form of prescribed contraceptive pills. This type of treatment is effective for fibroids that cause heavy or excessive bleeding. By reducing the thickness of the uterine wall, excessive bleeding is controlled.

Uterine Fibroid embolization

Embolization is a process where the blood supply to the fibroids is cut off. This results in the fibroids shrinking and getting damaged. 

Ultrasound-based treatment

Treatment with ultrasound uses higher energy ultrasound waves than those of a regular ultrasound. These waves are targeted on the fibroids, destroying them without causing any damage to the healthy surrounding tissue.

Surgery

There are different surgical procedures used to deal with particularly problematic fibroids. These are undertaken having also put into consideration the patient’s overall health, family building plans, and age. Let us look into these surgeries in a bit more detail:

Hysteroscopic Myomectomy 

In this surgery, a hysteroscope is used to remove the fibroids, and is done on small but problematic fibroids. In the procedure, the hysteroscope is directed into the uterus via the cervix, and using a small surgical tool, the fibroids are burnt away. This is usually an outpatient procedure.

Laparoscopic Myomectomy

In this surgery, small incisions are made around the surgical site, and surgical tools are passed through them. It is typically used on larger fibroids, and the procedure also employs a camera and monitor to enable the surgeon to see while they work. If the fibroids are too big to fit through the incisions, open surgery would be a more effective option. 

Full Hysterectomy

This surgery is often a last resort, and is done in very extreme cases, where the fibroids prevent a person from going about their daily life as usual. The main reason it is a last resort is that it requires the entire uterus to be removed, which will mean that the patient will not be able to build a family naturally. After this procedure, a patient will no longer experience menstruation. Whereas all other methods of treating fibroids do not prevent a person from building a family, a full hysterectomy will.

Emergency medical care must be sought immediately if you experience severe vaginal bleeding, weakness, lightheadedness and fatigue. It could be that you are experiencing severe complications related to fibroids.

Summing It Up

As we have seen fibroids can be treated when they become problematic. They neither cause infertility, nor does treating them cause a person to become infertile, with the exception of full hysterectomies. Overall, fibroids are not cancerous, and they are also not harmful. If there are further questions you may have about fibroids, their treatment, or fertility, do not hesitate to contact the team of compassionate professionals at Virginia Fertility & IVF.