The Fibroid-Fertility Connection
It is simultaneously National Fertility Awareness week and Fibroid Awareness week. The fibroid-fertility connection is important to understand as couples consider infertility treatments. Fibroids are non-cancerous growths, originating from the uterus. A brief overview of fibroids will help illustrate how they can disrupt the normal pattern of a woman’s reproductive cycle, and interfere with conceiving a child.
What Causes Fibroids?
Fibroids are “fibrous” tough masses that require estrogen and progesterone – the female hormones – for growth.
Where Do Fibroids Grow?
- Outside or within the outer lining (Serosal)
- On stalks, extending from the uterus (Pedunculated)
- Within the uterine muscle (Intramural)
- The endometrial lining, growing into the space inside the uterus. (Submucosal)
- Cervical fibroids are rare; most fibroids develop from the uterine muscle (myometrium).
THE FIBROID-FERTILITY CONNECTION
Unless removed, there is a chance that fibroids can have a negative effect on trying to have a baby. The location of the fibroid, and not necessarily the size are important to understand for fertility. The two types of fibroids that need to be surgically removed through a procedure called a myomectomy, are submucosal, those in the uterine cavity, and intramural, those within the uterine muscle.
In the Uterine Cavity
Fibroids in the cavity of the uterus, also known as submucosal fibroids, can be a cause of infertility. In a normal pregnancy, the embryo (the egg and the sperm combined) attaches to the uterine lining, with the placenta developing and obtaining blood supply from the uterine muscle. These fibroids can prevent the embryo from attaching, can get in the way of conceiving, or can result in miscarriage (loss of the pregnancy).
In the Uterine Muscle
Intramural fibroids (fibroids in the muscle) can also prevent conception. Fibroids can obstruct the fallopian tubes, resulting in difficulty in becoming pregnant. Fibroid blockage of the tube will not allow the embryo to pass into the uterine cavity, where it could successfully implant on the endometrial lining.
Fibroids can also cause problems during pregnancy as well. These include:
- Placental abruption – detachment of the placenta, causing bleeding and loss of pregnancy.
- Abnormal growth of the pregnancy – occurring from fibroids affecting blood flow or the size of the fibroids, preventing the baby from growing properly.
- Pre-term labor and birth – preventing normal growth leading to contractions and early labor. Early labor may lead to an early delivery of the baby and possible developmental problems.
SURGICAL TREATMENT FOR FIBROIDS INCREASES SUCCESS RATES WITH FERTILITY TREATMENTS OR NATURAL CONCEPTION
For some women, the hormone therapy that is part of fertility treatments can also lead to fibroid growth, creating an unfortunate barrier to conceiving a child. Read Ljubica’s story Fertility Surgery: A Love Story. Along the way, as women undergo IUI or IVF treatments, it’s important to consult with a GYN surgical specialist to ensure your financial and emotional investment has a higher chance of paying off.
Fertility treatments can be a major investment for some families. The cost is worth it if the result is positive. From our March 15, 2015 article Improve IVF Success Rates With GYN Surgery:
“Unsuccessful infertility treatments are common. After the 2nd or even 3rd very expensive treatment (avg is ~ $12,000, plus additional medication costs of $3,000 to $5,000. Additional genetic testing can push the total upwards of $25,000 per treatment.), women often discover that they have a treatable GYN condition like fibroids or endometriosis* that is getting in the way. If these conditions are treated early with minimally invasive laparoscopic GYN surgery, IVF success rates are higher, and there is improvement in carrying a child to term.”
A study conducted over 14 years found that for women in India, laparoscopic removal of fibroids increased pregnancy rate to 37.2% & 50% in donor oocyte IVF.
LAAM MYOMECTOMIES AT THE CENTER FOR INNOVATIVE GYN CARE
Women who wish to retain their uterus for fertility can have their fibroids safely removed with the LAAM technique. LAAM stands for Laparoscopic Assisted Abdominal Myomectomy. It is a fusion of the best parts of laparoscopic and open procedures. Using a very small incision at the bikini line, and an even smaller incision at the belly button, the CIGC surgical specialists are able to safely remove fibroids without damaging the uterus. The procedures are performed in an outpatient setting.
LAAM myomectomies can be performed on any patient regardless of fibroid size, number, or location.
To learn more about the LAAM procedure, please watch Helene’s story.