Hi everyone. My name is Samir Babayev, M.D., and I am fertility specialist and reproductive surgeon and IVF clinic director here at Mayo Clinic, Rochester, Minnesota.

How can fibroids impact fertility? Many women who have fibroids can get pregnant naturally. Treatment may not be even necessary for conception. That said, fibroids are present in 10 percent of infertile women and maybe a sole cause of infertility. For example, submucosal fibroids, a type of a fibroid that grows and bulges into the uterine cavity, increases the risk of infertility and pregnancy loss. The main reason for this is that sudden because of fibroids distort the uterine cavity and make it more difficult for pregnancy to attach itself. Bottom line, while fibroids may cause infertility for some women, other explanations for infertility are more common. If you are having trouble conceiving or maintaining a pregnancy, I recommend you see a fertility specialist to explore other possible causes before attributing the issue to fibroids.

Should I have my fibroid treated/removed prior to attempting pregnancy? I tell my patients that fibroids are like real estate. It is all about location and size. It is well-known that larger fibroids, and especially those closer to the inside lining of the uterus, may cause trouble with pregnancy and delivery. Medium and large sized fibroids can impact surrounding organs by causing pressure on the bladder, bowel, causing symptoms like frequent urination, difficulty emptying the bladder, and constipation. Because uterus sits close in close proximity to rectum and bladder, medium and large sized fibroids may pressure these organs. It isn't inherently dangerous, however, these fibroids can lead to uncomfortable symptoms and even pain.

What will happen to my fibroids if I become pregnant? Any complications that can happen during pregnancy? While there is a large amount of research on fibroids in non-pregnant patients, data is limited on how fibroids can affect pregnancy. During pregnancy, fibroids tend to grow in size, but most will shrink by the postpartum period. Thankfully, we do know that most patients with fibroids will have an uneventful pregnancy and delivery. Having a few small fibroids is rarely cause for concern. However, depending on your fibroids location, size, how many you have, certain problems may occur during pregnancy. Among other issues, fibroids may cause the placental attachment abnormalities, restrict the growth of the baby, increase the risk of preterm delivery, and bottom-down instead of head-down presentation at the time of delivery.

What sort of procedures are recommended when you want to get pregnant in the future? For women experiencing difficulty with uterine fibroids and infertility, there are treatment options that may help. Here at Mayo Clinic, we offer all available options ranging from medications to non-invasive treatments and surgery. Based on your goals and symptoms, this might change. Most women who are concerned about future fertility do choose to do fibroid removal surgery, or it's also known as myomectomy. That said, I recommend seeing a fibroid specialists to help you to choose the best available treatment. For more information about our fibroid clinic, please go to MayoClinic.org.

How long do I have to wait after a fibroid treatment to try to get pregnant? The time needed for healing of the uterus after fibroid treatment depends on the treatment type and extent. For example, for a myomectomy, the suggested waiting time could be as short as two weeks or up to three to six month before attempting to conceive.

March 19, 2021