Can Uterine Fibroids Affect Your Fertility? What Every Woman Should Know

By Author: Center for endometriosis and fertility
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Uterine fibroids are extremely common, yet many women do not realize how much these non-cancerous growths can affect their ability to conceive. Whether you are planning a pregnancy soon or simply want to understand your reproductive health, learning how fibroids develop, where they grow, and how they interact with the uterus can help you make informed decisions about your fertility and future family planning.

How Fibroids Are Linked to Fertility

Fibroids are non-cancerous growths that develop in or around the uterus. While many fibroids never cause symptoms or reproductive problems, some can change the shape of the uterine cavity, making it more difficult for an embryo to implant and develop properly during early pregnancy.

The connection between fibroids and fertility depends largely on their size and location. Consulting experienced fibroid care specialists in Los Angeles can help determine whether a fibroid is affecting your ability to conceive or simply requires ongoing observation.

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... Why Location and Size Matter

A small fibroid located on the outside of the uterus may have little to no effect on fertility, while even a relatively small fibroid growing inside the uterine cavity can interfere with implantation and increase pregnancy risks.

Submucosal Fibroids and Fertility

Submucosal fibroids develop just beneath the uterine lining and often extend into the uterine cavity. Because they occupy the same space where an embryo would implant, they are among the fibroids most likely to reduce fertility and increase the risk of early pregnancy loss.

Many physicians recommend removing submucosal fibroids before pregnancy because they are associated with higher rates of implantation failure and miscarriage. A hysteroscopic myomectomy can often remove these fibroids without requiring a large abdominal incision.

Intramural Fibroids and Fertility

Intramural fibroids grow within the muscular wall of the uterus. Smaller fibroids often have little impact on fertility, but larger ones may distort the uterine cavity or reduce blood flow to the uterine lining, making implantation more difficult.

Treatment recommendations depend on the fibroid's size, growth pattern, and proximity to the uterine cavity. In many cases, careful monitoring is appropriate before considering surgery.

Subserosal Fibroids and Fertility

Subserosal fibroids grow on the outer surface of the uterus and extend outward into the pelvis. Because they do not directly affect the uterine cavity, they rarely interfere with conception or embryo implantation.

Although these fibroids are generally less likely to affect fertility, very large subserosal fibroids may place pressure on surrounding organs or contribute to complications later in pregnancy. Routine monitoring helps ensure any changes are identified early.

Fibroids and Miscarriage Risk

Certain fibroids, particularly submucosal fibroids, are associated with a greater risk of miscarriage. Changes to the shape of the uterine cavity can make it more difficult for a pregnancy to remain securely implanted during the first trimester.

However, many women with fibroids experience healthy pregnancies and successful deliveries. The overall risk depends primarily on the fibroid's exact location and whether it alters the uterine cavity.

Fibroids and Pregnancy Complications

Larger fibroids may increase the likelihood of complications during pregnancy, including preterm labor, abnormal fetal positioning, or delivery by cesarean section. These risks generally increase with the size and number of fibroids present.

With regular prenatal care and ultrasound monitoring, most women with fibroids have healthy pregnancies. Ongoing evaluation allows healthcare providers to monitor fibroid growth and adjust the delivery plan if necessary.

Diagnosing Fibroids Before Trying to Conceive

Ultrasound is usually the first imaging test used to diagnose uterine fibroids. In some situations, MRI or hysteroscopy may be recommended to provide a more detailed evaluation of the uterus and the exact location of each fibroid.

Women experiencing unexplained infertility or recurrent pregnancy loss are often evaluated for fibroids as part of a comprehensive fertility assessment. Early diagnosis can significantly improve treatment planning and reproductive outcomes.

Treatment Options to Protect Fertility

When fibroids interfere with fertility, myomectomy is often the preferred treatment because it removes the fibroids while preserving the uterus. The most appropriate surgical approach depends on the fibroid's size, number, and location.

Not every fibroid requires surgery. Small fibroids that do not cause symptoms or distort the uterine cavity are frequently monitored instead, particularly for women who plan to become pregnant in the near future.

Taking the Next Step for Your Fertility

Every woman's experience with uterine fibroids is unique. Understanding your diagnosis through a comprehensive fertility evaluation can help determine whether treatment or ongoing monitoring is the most appropriate approach. The Center for Endometriosis and Fertility provides personalized care to help women better understand their reproductive health and create an individualized treatment plan that supports their family-building goals.