Can Fibroids Cause Infertility?

Uterine fibroids (leiomyomas) are benign (noncancerous) tumors made of uterine muscle and other tissues. Fibroids are usually found in or around the uterus and sometimes the cervix. Fibroids are common—up to 80% of people with a uterus will have fibroids at some point during their childbearing years.

Fibroids are one factor that can affect your fertility or potential infertility, but certain types of fibroids can affect fertility differently. There are three types of fibroids, based on where they are found: 

  • Subserosal: Found in the outer wall of the uterus
  • Intramural: Found in the muscular layers of the uterine wall
  • Submucosal: Found in the inner lining of the uterus and may protrude into the uterine cavity

This article will discuss when and how fibroids may cause infertility, how fibroids are treated, and the outlook for pregnancy if you have fibroids.

Doctor discussing fertility with patient

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Fibroids and Fertility

Many people with fibroids can still get pregnant naturally. According to the American Society for Reproductive Medicine, 5% to 10% of infertile women have fibroids. Fibroids may be the sole cause of infertility in only 1% to 3% of people who have them. Most people with fibroids will not be infertile. 

Fibroids can affect your fertility in several different ways, depending on their size, location, and type. Submucosal fibroids specifically—a type of fibroid that bulges into and/or grows in the lining of the uterine cavity—may contribute to infertility or pregnancy loss.

The location of fibroids can have an impact on fertility. Some fibroids may block the fallopian tubes or change the shape of the uterus to prevent embryo implantation, for example. The size of fibroids can impact fertility, too. Uterine fibroids larger than four centimeters are associated with lower pregnancy rates.

Other Causes of Infertility

People with uterine fibroids may be affected by other factors that contribute to infertility. Some other common causes of infertility include:

  • Autoimmune disorders (e.g., Hashimoto’s disease, rheumatoid arthritis)
  • Endometriosis
  • Failure to ovulate
  • Menstrual cycle problems (e.g., short luteal phase)
  • Polycystic ovary syndrome (PCOS)
  • Primary ovarian insufficiency (POI) 
  • Sexually transmitted infections (e.g., chlamydia, gonorrhea) 
  • Structural problems of the reproductive system (e.g., damaged fallopian tubes, uterine abnormalities)
  • Unexplained infertility

How Fibroids May Cause Infertility

Fibroids can affect your fertility in a number of ways. Some examples include:

  • Fallopian tubes can be blocked by fibroids, making it difficult or impossible for a fertilized egg to reach the uterus and implant. 
  • Changes in the shape of the cervix due to fibroids can affect the number of sperm that enter the uterus.
  • Changes in the shape of the uterus due to fibroids can prevent the movement of sperm or implantation of an embryo.
  • Uterine lining thickness can be impacted by the presence of fibroids.
  • Blood flow to the uterine cavity is affected by the presence of fibroids.

Fibroid Treatment and Fertility

Many people with uterine fibroids wonder if getting fibroids treated or removed will improve their fertility. Most people with uterine fibroids are able to become pregnant without treatments. 

Some fibroids can make conceiving difficult or cause miscarriage, depending on their location, size, and type. If the fibroids distort the inside of the uterus, this can affect implantation. If fibroids obstruct the fallopian tube, cervix, or uterine cavity, this may block the migration of sperm and prevent fertilization of the egg. 

If you have fibroids and are struggling to conceive, it is important to undergo a basic fertility evaluation to determine the cause of infertility and determine what treatments may be needed.

The first step is to make an appointment with your OB-GYN. Your doctor will ask you questions about how long you’ve been trying to get pregnant and may run tests (e.g., bloodwork, diagnostic imaging tests) to determine what is preventing pregnancy.

Your doctor may also refer you to a fertility clinic, where you and your partner can be evaluated by a reproductive endocrinologist (RE) who may run additional tests to confirm the cause of infertility and discuss the next steps with you. 

Once the cause of infertility is identified, your OB-GYN or RE will recommend potential treatments to help you become and stay pregnant. 

Options

If fibroids are affecting your ability to become pregnant, you may want to consider treating or removing them. 

Some fibroid treatments—such as hormonal contraceptives and gonadotropin-releasing hormone agonists (GnRHa)—block the production of hormones that lead to ovulation and pregnancy, so you can’t become pregnant while using these treatments.

While hormonal contraceptives are generally prescribed to prevent heavy menstrual bleeding and do not have an effect on fibroids themselves, GnRHa medications can help reduce the size of fibroids. They are usually used short term to shrink fibroids before surgery.

If you prefer to have your fibroids removed before getting pregnant and/or fibroids are the cause of your infertility, a myomectomy may be performed. Myomectomy is the surgical removal of fibroids from the uterus. It is the best fibroid treatment for people who are trying to or want to become pregnant.

Myomectomy may improve your chances of pregnancy if you have submucosal fibroids, but not if you have other types of fibroids.

Treating Fibroids for Fertility

It is unclear if removing fibroids improves fertility or prevents pregnancy complications. Some studies show positive outcomes after these procedures, but more research is needed.


Uterine artery embolization (UAE) is a procedure that involves threading a thin tube into the blood vessels that supply blood to the fibroid(s). Plastic or gel particles are injected into the blood vessels to block blood supply to the fibroid, causing it to shrink.

While pregnancy is possible in some people after UAE, it is not recommended for people who desire future pregnancy. Research shows that chances of pregnancy are lower and the rate of miscarriage can be as high as 56% after the procedure.

Talk with your OB-GYN or RE about your fibroid treatment options if you are trying to conceive now or planning to in the future. There are also natural fibroid treatments that you may want to consider.

Outlook

Most people with fibroids have normal pregnancies carried to term. However, 10% to 30% of pregnant people with fibroids may experience fibroid-related complications with the pregnancy and/or labor, including:

  • Bleeding in early pregnancy
  • Breech presentation
  • Cesarean section
  • Pain, most often in women with fibroids larger than five centimeters in diameter 
  • Postpartum hemorrhage
  • Preterm delivery
  • Slow labor
  • Abnormal placenta
  • Incomplete cervical dilation

Having fibroids does not necessarily mean your pregnancy will be high risk. Your OB-GYN will monitor your pregnancy closely and will work with you to look out for signs of any potential problems.

In some cases, fibroids shrink or even “die off” during pregnancy due to their blood flow being redirected to the fetus instead. 

Frequently Asked Questions

What size fibroids should be removed?

Larger fibroids are associated with lower chances of getting pregnant and carrying a full-term pregnancy, but the jury’s still out on what size fibroids should be removed.

Whether fibroids should be removed before pregnancy depends on many factors, including location, size, and number of fibroids, as well as your past and current health history. 

How do you deal with fibroids during pregnancy?

Most fibroids do not interfere with pregnancy or grow during pregnancy. Most people with fibroids have normal pregnancies without complications.

Depending on the size, location, and growth rate during pregnancy, some fibroids may affect the baby’s positioning at the time of delivery. This can increase the chances of requiring a cesarean section to deliver the baby. 

How do you know if you have fibroids?

Heavy bleeding, painful periods, a feeling of fullness in the lower stomach, and frequent urination are all symptoms of fibroids. The only way to be certain you have fibroids is to see your doctor.

They may feel a lump or mass on the uterus and/or may order imaging tests (usually ultrasound) to confirm that you have fibroids.

Summary

Uterine fibroids are a common problem. They often do not affect fertility or cause pregnancy complications, but they may due to location, size, and other factors. There are treatment options that may preserve fertility.

A Word From Verywell 

Uterine fibroids may affect your fertility and impact your ability to carry a pregnancy. However, most people with fibroids are able to conceive and carry a pregnancy full term. If you have uterine fibroids and your fertility is on your mind, talk with your OB-GYN to discuss your treatment options and next steps.

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  1. Giuliani E, As-Sanie S, Marsh EE. Epidemiology and management of uterine fibroids. Int J Gynaecol Obstet. 2020;149(1):3-9. doi:10.1002/ijgo.13102

  2. American Society for Reproductive Medicine. Fibroids and fertility. Updated 2015.

  3. Al-Hendy A, Myers ER, Stewart E. Uterine fibroids: burden and unmet medical deed. Semin Reprod Med. 2017;35(6):473-480. doi:10.1055/s-0037-1607264

  4. Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach. Obstet Gynecol Clin North Am. 2012;39(4):521-533. doi:10.1016/j.ogc.2012.09.005

  5. Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2016;34:66-73. doi:10.1016/j.bpobgyn.2015.12.001

  6. Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are some possible causes of female infertility? Updated January 31, 2017.

  7. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Medication-related treatments for fibroids. Updated November 2, 2018.

  8. University of Michigan Health. Myomectomy. Updated July 17, 2020.

  9. Desai P, Patel P. Fibroids, infertility and laparoscopic myomectomy. J Gynecol Endosc Surg. 2011;2(1):36-42. doi:10.4103/0974-1216.85280

  10. Karlsen K, Hrobjartsson A, Korsholm M, Mogensen O, Humaidan P, Ravn P. Fertility after uterine artery embolization of fibroids: a systematic review. Arch Gynecol Obstet. 2018;297(1):13-25. doi:10.1007/s00404-017-4566-7

  11. Milazzo GN, Catalano A, Badia V, Mallozzi M, Caserta D. Myoma and myomectomy: poor evidence concern in pregnancy. J Obstet Gynaecol Res. 2017;43(12):1789-1804. doi:10.1111/jog.13437

  12. Shields J. Can uterine fibroids harm my pregnancy? UT Southwestern Medical Center website. March 31, 2020.

  13. Supermaniam S, Thye WL. Intramural fibroid and fertility—to operate or notGynecol Pelvic Med. 2019;2:31-31. doi:10.21037/gpm.2019.11.01