Yes, you can conceive a baby with fibroids. You probably know many women who successfully got pregnant with fibroids. They are extremely common, affecting some 20 to 70 percent of women over the course of their reproductive lives. They are usually harmless. Even if fibroids have impacted your quality of life, your doctor should be able to advise you or refer you to a specialist who can help you with any conception issues. Their size, location, and number can impact your ability to conceive, and they can also cause complications during pregnancy and birth.

What are fibroids?

Fibroids are solid growths in or around your womb. They are made of muscle and fibrous tissue and can range from pea-sized to melon-sized. They are non-cancerous and do not increase your risk of uterine cancer. The cause of fibroids is unknown but believed to be linked to the hormones oestrogen and progesterone. Symptoms of fibroids vary and can include heavier, more painful, and prolonged periods; pressure or discomfort in the abdomen; bladder problems; lower back pain; and discomfort during sex.

How are fibroids diagnosed?

Fibroids may be discovered by chance during a gynaecological examination, test, or scan for something else. If a doctor is looking for them, you'll usually need to have an ultrasound scan.

Can fibroids be cured?

Small fibroids may shrink and disappear on their own without treatment. There are some medications that work to shrink them. These drugs put you in a temporary menopausal state and come with significant potential side effects, particularly for your bone health. Your fibroids may grow back if you come off them, so they should be carefully considered. Fibroids can be removed with surgery, conducted through your vagina or naval, depending on the fibroid’s size. In some cases, a hysterectomy is the only way to keep them from coming back completely. Many women find their symptoms disappear in menopause.

How might fibroids impact my ability to get pregnant?

The location of your fibroids really matters. If they're not distorting your uterine cavity, blocking your fallopian tubes, or preventing sperm from reaching your eggs, your fibroids usually won't interfere with implantation.

As with any chronic condition, it's very important to ensure your fibroids are well managed when you are trying to have a baby. The stress, low mood, lack of sleep, and inactivity that could result from untreated fibroids will negatively impact your fertility.

Should I have my fibroids removed to improve my fertility?

There may be medical indications, such as heavy bleeding, that prompt your doctor to recommend that you have fibroids removed anyway. The size, number, and particularly the location of your fibroids will influence whether your doctor recommends that you remove them for fertility reasons. In general, submucosal fibroids, which are located inside the womb, pose the greatest risk.

Should I have my fibroids removed to protect my pregnancy?

This will depend on the location, size, and number of your fibroids. Fibroids have been linked to premature birth, miscarriage in the first and second trimesters, placental abruption, the need for a caesarean delivery, and postpartum haemorrhage. In pregnancy, they can sometimes cause problems with a baby's development.

Fibroid pain may increase in pregnancy, and this will usually be managed with pain medication. Always ask your doctor about anything you want to take that is not a prescription. If your fibroids increase in response to your pregnancy hormones, they will usually regress after birth.

Fibroids can also cause vaginal bleeding in pregnancy. It is vital that you call your doctor or hospital immediately if you have any bleeding when you're pregnant, if your baby is moving less, or if they've stopped moving.

Fibroid removal during pregnancy is rare and won’t usually be recommended unless the benefits are thought to outweigh the risks. Fibroid surgery disturbs the uterine environment and can be risky for mum and baby. If you have concerns about fibroids impacting your pregnancy, raise them as early as possible with your doctor and midwife.

To learn more about how to stay well while trying to conceive or how to have a healthier pregnancy, watch Unii's Preconception and Pregnancy Journeys with Dr. Shree Datta.

Can I get pregnant with fibroids?

Unii looks at how this sometimes painful condition can impact fertility and pregnancy.