MANY people with fibroids wonder if getting fibroids treated or removed will improve their fertility. Although fibroids and surgical removal may seem scary, they are a common issue that many women live with.
Research shows that between 20% and 80% of women will develop fibroids by the age of 50, showing just how many women may live normal lives with undiagnosed fibroids or experience any symptoms of fibroids.
Do fibroids cause infertility and should they be removed to increase fertility? Dr Abayomi Ajayi, the MD Fibroid Care Centre at Nordica, Lagos, says, it is a common misconception that fibroids cause infertility, but the truth is that their presence only signifies potential roadblocks to fertility.
Ajayi, a fertility expert declared: “Fibroid does not cause infertility, but it can interfere with fertility. We know that about 20 to 25 per cent of women with infertility have a fibroid. But it is only 1 to 2 per cent of these women have infertility due to fibroid. These few women have infertility because the fibroid is blocking the fallopian tubes or stopping the fertilized egg from implanting in the womb.”
The size, location, and number of fibroids is key to whether they may affect a woman’s ability to conceive and give birth without issue. The location of fibroids can prevent the sperm and egg from joining together for conception. The shape of the cervix (mouth of the womb) may change allowing less sperm to enter the womb.
Although many people associate fibroids with infertility, he stated that some women thought to have infertility could have other underlying factors contributing to infertility besides fibroids.
A fertility specialist can help assess if fibroids might be hampering conception. “Most women with fibroids will not be infertile. If you have fibroids, you and your partner should be thoroughly evaluated to find other problems with fertility before fibroids are treated,” he added.
A lot of women have fibroids and they keep it to themselves because they don’t want to surgically remove them even though a majority of these women also have infertility. So they need to have a good assessment of their fertility before burdening the fibroid.
Howbeit, he declared that because many Nigerians think that fibroid is the cause of their infertility, they want to treat fibroid without giving any consideration to infertility. But in some of the instances, the male factor is the cause of infertility and not the fibroid in these couples.
People with fibroids may be affected by other factors that contribute to infertility. Some other common causes of infertility include damaged fallopian tubes, endometriosis, failure to ovulate, menstrual cycle problems, polycystic ovary syndrome (PCOS), and sexually transmitted infections like Chlamydia and gonorrhoea.
Dr Ajayi, however, said that even if the fibroids need to be removed because it is thought to be the reason for infertility, care must be taken to ensure that doing this would not deform the womb.
More importantly, he said where many fibroids are found, the number to remove should be decided based on whether the woman wants to have all the fibroids removed to treat her symptoms or to remove only those that can compromise her chances of getting pregnant.
“For us involved in assisted reproductive technology (ART), we come across women that the only reason they cannot get pregnant again even through In-vitro fertilization (IVF) is that the doctor has gone to remove like 40 to 50 fibroids and have deformed their womb,” he added.
Can women with fibroids can get pregnant naturally? Many people with fibroids wonder if getting fibroids treated or removed will improve their fertility. Professor Chris Aimakwu, a consultant obstetrician and gynaecologist, said where the fibroid is affecting conception, when it is removed it improves their chances of conception.
According to him, “we know the kind of fibroid that can compromise fertility, but our patients’ satisfaction is key. When you do surgery for a patient with fibroids, especially when the woman has a huge stomach about the size of a 36-week-sized womb and can hardly move around, sometimes, it is cosmetics that are most satisfactory to the patient.
“Sometimes you can do less invasive surgery to remove the fibroids so that the woman can conceive. Of course, she can always decide later on to come back to have the leftover fibroids cleared so that she is free of those symptoms. So most times, you have to strike a balance between what the patient wants and what she is going through.”
Heavy bleeding, painful periods, a feeling of fullness in the lower stomach, and frequent urination are all symptoms of fibroids. But the only way to be certain of having fibroids is to see the doctor who may be able to feel a lump or mass in the womb and/or may order an ultrasound to confirm fibroids.
Whether fibroids cause infertility is the subject of considerable speculation and the impression that fibroids contribute to infertility has arisen from several case series, mostly without controls, where a varying proportion of previously infertile women conceived after their fibroids had been removed.
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