Fibroids not always responsible for infertility — Prof Aimakhu

Many Nigerian women believe that fibroids can affect fertility, particularly when they are large, numerous, or located in parts of the womb that interfere with conception or pregnancy.

For many women, being diagnosed with fibroids can therefore bring fear, uncertainty and pressure to seek treatment. Some turn to hospitals and medical specialists, while others may also consider traditional remedies or advice from family and community members.

Ironically, fibroids are not necessarily a barrier to pregnancy, according to Professor Chris Aimakhu, who says only a minority of infertility cases can be directly attributed to the condition.

Aimakhu, a professor of obstetrics and gynaecology at the University College Hospital, Ibadan, explained that while fibroids can affect a woman’s ability to conceive, their impact largely depends on their size, location and whether they interfere with the uterus or fallopian tubes.

His comments came during a discussion on female fertility and ovulation, where he also stressed the importance of women understanding their menstrual cycles and recognising their fertile periods.

According to Aimakhu, monitoring ovulation should not only concern couples trying to have children. Women who menstruate can learn to understand their individual cycles, whether or not their cycle follows the commonly referenced 28-day pattern.

READ ALSO: Check out 5 natural ways to prevent Fibroids 

“If you have a 28-day cycle, you know you are going to ovulate on the 14th day,” he explained, noting, however, that not every woman has a 28-day cycle.

He said women can now rely on technology to make monitoring easier, with menstrual-tracking applications helping users record their periods and estimate when ovulation is likely to occur.

Beyond applications, Aimakhu pointed to ovulation-prediction kits that detect the luteinising hormone (LH) surge in urine. The LH surge is an important indicator that ovulation is approaching.

He said some tests can also use blood samples, while simpler urine-based kits are widely available.

Aimakhu cautioned against assuming that ovulation is the explanation for every case of infertility.

He estimated that ovulation-related problems account for about 30 to 40 per cent of infertility cases, while emphasising that other factors can occur alongside ovulation problems.

READ ALSO: Check out 5 natural ways to prevent Fibroids 

According to him, a woman who confirms that she is ovulating but still does not become pregnant should not necessarily conclude that an ovulation-tracking application or test has failed.

Rather, he said, such a woman may need further investigation to identify other possible causes of infertility.

Addressing concerns about fibroids, Aimakhu said studies suggest that fibroids account for roughly 10 per cent of infertility cases but stressed that their effect depends largely on their characteristics and location.

“Fibroids and infertility studies will tell you fibroids are the cause of infertility, maybe one in 10 patients. But then, it all depends on the location,” he said.

He explained that submucous fibroids, which grow into the cavity of the womb, can interfere with implantation. Fibroids may also become problematic when they obstruct the openings of the fallopian tubes or significantly alter the uterine lining.

Large fibroids, he added, may sometimes interfere with where a fertilised egg implants. They can also become larger during pregnancy and, in some cases, contribute to complications such as recurrent miscarriage.

However, the professor warned against treating every fibroid as a cause of infertility or automatically recommending surgery.

Aimakhu said doctors assessing a woman with fibroids and fertility concerns should look beyond simply identifying the presence of a fibroid.

An ultrasound scan can help determine the size and location of the growths, while additional investigations, including hysteroscopy, may be used where necessary to examine the inside of the womb and establish whether fibroids are interfering with fertility.

He stressed that surgery itself can sometimes introduce complications, particularly through scarring and problems associated with healing.

“It’s not all cases of fibroids,” he said, adding that he had seen women with multiple fibroids who had successfully become pregnant and delivered children.

In such cases, the fibroids may not have prevented conception but could later cause troublesome symptoms, including heavy menstrual bleeding.

For women trying to conceive, Aimakhu’s message is that finding a fibroid on a scan should not immediately be interpreted as an explanation for infertility.

Instead, fertility assessment should consider the whole reproductive picture, including ovulation, the uterus, fallopian tubes and other possible factors affecting either partner.

Similarly, knowing that a woman is ovulating does not guarantee pregnancy. Ovulation is an essential part of conception, but it is only one component of the process.

For couples struggling to conceive, the appropriate approach, according to Aimakhu, is therefore a proper medical evaluation rather than attributing infertility to a single finding such as a small fibroid.

Ultimately, the presence of fibroids does not automatically take pregnancy off the table. For many women, even those with multiple fibroids, conception and successful pregnancy remain possible.