Fibroid and Fertility – Femelife Fertility
Fibroid tumours are commonly found in approximately 20-40% of all reproductive age women.
They can be located in the wall of the uterus (intramural), on the outside of the uterus (subserosal), within the uterine cavity (submucosal), on a thin stalk (pedunculated).
Fibroid tumours can exist without any symptoms called asymptomatic fibroids. However, they can also cause a variety of symptoms depending on their size, location and the absence or presence of complications such as torsion (twisting) or degeneration. The most common symptoms are heavy menstrual bleeding accompanied by pain. Sometimes, especially when a fibroid protrudes into the uterine cavity, it can destroy the endometrial lining and produce irregular or continuous bleeding.
Fibroids can cause fertility problems due to various reasons like –
1)May interfere with sperm migration, ovum transport and embryo implantation.
2) Alteration of the uterine cavity contour causing mechanical pressure or by the occurrence of abnormal uterine contractility.
3) Local inflammation associated with the presence of submucosal fibroids may result in a hostile endometrial environment that impairs sperm transport and embryo implantation
4) An inadequate blood supply to the endometrium has also been advocated to explain reduced embryo implantation.
5) If fibroids are localized near the cervix or near the tubal ostia, the anatomical distortion may reduce access to the tubes by ejaculated sperm, whereas large cornual lesions might impair ovum retrieval by the tubes.
Fibroids causing symptoms will need treatment and usually they are treated by medications as first line therapy. Drugs like progestin’s, tranexamic acid, progestin containing IUD, Gonadotropin releasing hormone agonist have been used with variable results. Surgery is advised in cases where medical management fails. Infertility due to fibroid is treated according to the associated cause, like in tubal factor infertility patients are suggested to go for IVF.