Women’s Health | IVANA MD | Missouri City, TX
Finding out you have uterine fibroids when you are trying to start or grow your family can feel alarming. Questions often follow: Will I be able to get pregnant? Could fibroids cause a miscarriage? Do I need surgery before trying?
These are valid concerns. The good news is that many women with fibroids become pregnant and have healthy pregnancies. However, fibroids can affect fertility and pregnancy differently depending on their size, number, and especially their location.
Can You Get Pregnant with Fibroids?
Yes. Having fibroids does not automatically mean you will have difficulty getting pregnant. Many women with fibroids conceive without fertility treatment.
In some cases, however, fibroids can interfere with fertility, particularly when they change the shape of the uterine cavity. The effect depends largely on where the fibroid is located rather than simply whether a fibroid is present.
How Can Fibroids Affect Fertility?
Fibroids may affect fertility by:
- Distorting the uterine cavity, which can interfere with implantation
- Affecting the uterine lining and its ability to support implantation
- Occasionally affecting the fallopian tubes or the normal anatomy of the reproductive tract
- Causing changes in the uterus that may make conception or implantation more difficult
Not every fibroid causes these problems, and many women with fibroids have no fertility-related complications.
Which Fibroids Are More Likely to Affect Fertility?
Location matters.
Submucosal fibroids, which grow into the uterine cavity, are the type most consistently associated with reduced fertility and pregnancy rates. Removing cavity-distorting submucosal fibroids may improve the chances of pregnancy in appropriately selected patients.
Intramural fibroids, which grow within the muscular wall of the uterus, have a more complicated relationship with fertility. Larger intramural fibroids, particularly those that distort the uterine cavity, may affect reproductive outcomes. However, surgery is not automatically recommended for every intramural fibroid.
Subserosal fibroids, which grow on the outside of the uterus, generally have less effect on fertility because they do not directly distort the uterine cavity.
Fibroids and Pregnancy
Many women with fibroids have uncomplicated pregnancies. However, fibroids can be associated with an increased risk of certain pregnancy complications, including:
- Miscarriage
- Preterm birth
- Placental abnormalities
- Fetal malposition, such as breech presentation
- Cesarean delivery
The risk varies according to factors such as fibroid size, number, and location.
Fibroids may also change in size during pregnancy. Some grow, particularly in early pregnancy, while others remain stable or become smaller. Rapid changes can sometimes cause pelvic or abdominal pain.
Do Fibroids Need to Be Treated Before Pregnancy?
Not necessarily.
Whether treatment is appropriate depends on the fibroid’s location and size, your symptoms, your fertility history, and whether it is affecting the uterine cavity.
Small fibroids that are not distorting the uterine cavity and are not causing significant symptoms may simply be monitored.
When treatment is recommended, myomectomy—surgical removal of fibroids while preserving the uterus—may be considered for women who wish to become pregnant. The approach can include hysteroscopic surgery for certain submucosal fibroids or laparoscopic/open surgery for other types.
Myomectomy has potential benefits and risks, including scar tissue formation and, depending on the depth and location of the uterine incision, possible implications for delivery in a future pregnancy.
Can You Have Fertility Treatment with Fibroids?
Yes. Women with fibroids may pursue fertility treatments such as IUI or IVF. However, whether fibroids should be treated before fertility treatment depends on the individual situation.
If you have fibroids and are trying to conceive, an OB-GYN or fertility specialist can assess the number, size, and location of your fibroids and determine whether they are likely to affect your fertility or pregnancy.
At IVANA MD, we provide individualized gynecologic care and can help you understand your options and coordinate care with fertility specialists when needed.
📍 Schedule your women’s health consultation with IVANA MD in Missouri City, TX.
📞 346-585-4077
4220 Cartwright Road, Suite 201, Missouri City, Texas 77459
References:
American College of Obstetricians and Gynecologists. (2025). Uterine fibroids. https://www.acog.org/womens-health/faqs/uterine-fibroids
Stewart, E. A. (2015). Uterine fibroids. New England Journal of Medicine, 372(17), 1646–1655. https://doi.org/10.1056/NEJMcp1411029
Stewart, E. A., Cookson, C. L., Gandolfo, R. A., & Schulze-Rath, R. (2017). Epidemiology of uterine fibroids: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 124(10), 1501–1512. https://doi.org/10.1111/1471-0528.14640
Pritts, E. A., Parker, W. H., & Olive, D. L. (2009). Fibroids and infertility: An updated systematic review of the evidence. Fertility and Sterility, 91(4), 1215–1223. https://doi.org/10.1016/j.fertnstert.2008.01.051
