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Are uterine fibroids the reason why you are not able to conceive?

By Dr. Shweta Goswami

The female reproductive system is quite complex and there is a plethora of reproductive health problems that can affect your ability to conceive and prevent you from living your dream of having a baby.  Uterine fibroids are one such problem that can lead to infertility, however, there is nothing to worry about as IVF treatment specialists offer a variety of treatment options to help women with uterine fibroids start their family. One of the major challenges that we face is that despite being the most common gynaecological disorder, a lot of women don’t know about uterine fibroids, and especially in rural India where there are tremendous taboos related to infertility.

Now, the question arises, ‘What are uterine fibroids?’

These are non-malignant growths that develop in the uterus of the women of child-bearing age. These are commonly referred to as leiomyomas or simply myomas. While some of these fibroids can be as small as a tiny seedling, Others can be quite large. Also, it is possible to have more than one fibroid i.e. multiple fibroids. In rare cases, the fibroids can expand in size causing the uterus to swell up.

Fibroids are categorized on the basis of the location where they originate. For instance, Intramural fibroids originate within the muscular wall of the uterus whereas submucosal fibroids bulge into the uterine cavity. In case the fibroids bulge out of the uterine cavity, these are known as subserosal fibroids.

Symptoms you should not ignore

Most of the women with uterine fibroids do not show or experience any symptoms and the problem usually becomes evident when they are unable to conceive and opt for proper evaluation. The symptoms also depend upon the location of the fibroids, their size and number. Some of the common symptoms associated with uterine fibroids include:


  • Heavy blood flow during menstruation

  • Prolonged menstrual flow that extends for more than a week

  • Pressure or pain in the pelvic region

  • Not being able to pass out urine freely

  • Constipation and bloating

  • Pain in the back and legs

  • While these symptoms do not necessarily indicate the prevalence of uterine fibroids, it is pertinent to see a specialist if

    • The pelvic pain does not go away

    • You are experiencing spotting between periods

    • You are anaemic

    • You are experiencing chronic pain during your periods


    Wondering what causes uterine fibroids?

    Although the exact cause of uterine fibroids cannot be determined, these factors might be held responsible for it:

    • Genetic mutations - Fibroids can be a result of abnormal changes in the genes

    • Abnormal hormone levels – excessive production of Oestrogen and progesterone, hormones which are responsible for the development of uterine lining which is then shed during menstruation, also promote the growth of fibroids. It has been found that fibroids contain elevated oestrogen and progesterone receptors as compared to normal uterine muscle cells.

    • Other growth factors – These include insulin-like growth factors that may affect fibroid growth.

    • Extracellular matrix (ECM) – It is a material that makes the uterine cells stick together. Fibroids have elevated ECM levels that make them fibrous. It also stores growth factors and causes biological abnormalities in the cells themselves.


    How fibroids affect your ability to conceive?

    Fibroids, if left untreated, can surely lead to a lot of complications. These are not life-threatening but can affect the quality of your life by leading to problems like anaemia, fatigue and persistent discomfort. If we talk about the impact of fibroids on pregnancy, these do not always interfere with pregnancy, however, submucosal fibroids have been found to be associated with infertility, miscarriage and still-birth. Fibroids can also trigger many complications like placental abruption and stunted fetal growth.

    Just having fibroids does not necessarily lead to infertility. It depends on its size and location within the uterus. See a specialist on advice for the same. Medications to shrink the fibroids act as contraceptives, hence may or may not be the right approach to deal with fibroids and subfertility. Some fibroids need to be ignored, some need medical treatment while some may require a keyhole surgery called myomectomy which may be done Hysteroscopically or laparoscopically depending on their size and location. All you need is proper evaluation, guidance and treatment which is offered at the leading infertility centres in the city.

    Assisted reproductive treatment options like IVF and IUI have proven to be successful in helping such women. If the fibroids are big or recurrent or if you wish to avoid surgery, you can even opt for surrogacy. It is possible to have a healthy and beautiful family even with fibroids. Consult a specialist today and explore the various options available.

    Is it possible to alleviate the risks of developing fibroids?

    As the exact cause of fibroids is not yet known, it is not possible to completely alleviate the risks. However, by making healthy lifestyle changes, it might be possible to decrease the risks. Doctors may also suggest certain medications to help with the same, especially if you fall in the risk category.

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