July is Fibroid Awareness Month, and if you’re in the middle of trying to get pregnant and just found out you have fibroids, you’re probably sitting with one big question: Do fibroids actually affect fertility?
Short answer: sometimes — but not always.
Fibroids are incredibly common, and many people with fibroids conceive without any difficulty at all. While fibroids can affect anyone, they are especially common among Black women, who are more likely to develop fibroids, often at a younger age and with larger or more numerous fibroids than women of other racial and ethnic groups. Depending on their size, number, and location, fibroids can interfere with conception or pregnancy in specific ways. Let’s walk through what matters, what doesn’t, and when it’s worth getting a closer look with a fertility specialist.
We help patients across South Carolina and North Carolina understand how conditions like fibroids fit into their fertility picture. No overwhelm. No guessing. Just clear answers and a fertility treatment plan that fits you.
First, What Are Fibroids?
Fibroids are noncancerous growths that develop in or around the uterus. They’re also called uterine leiomyomas. They can vary widely:
- Tiny, almost undetectable growths
- Larger masses that change the shape of the uterus
- Single fibroid or multiple fibroids at once
Some people never know they have them. Others experience symptoms like heavy periods, pelvic pressure, or cramping. And importantly for fertility, location matters more than almost anything else.
Do Fibroids Affect Fertility?
Fibroids can affect fertility in some cases, but not all fibroids cause problems.
The American Society for Reproductive Medicine (ASRM) notes that the fertility impact depends heavily on where fibroids are located within the uterus and how they interact with the uterine cavity. Here’s a simple way to think about it:
Fibroids That are Most Likely to Affect Fertility
- Submucosal fibroids (inside the uterine cavity)
- Fibroids that distort the uterine lining
- Large fibroids that significantly change uterine shape
These types can interfere with implantation or increase the risk of miscarriage.
Fibroids That Usually Do Not Affect Fertility
- Small intramural fibroids (within the uterine wall) that don’t distort the cavity
- Subserosal fibroids (on the outer surface of the uterus)
Many people with these fibroids conceive naturally without any treatment.
How Fibroids Can Make it Harder to Get Pregnant
When fibroids do interfere with fertility, it’s usually through one or more of these pathways:
1. Blocking Implantation
If a fibroid changes the shape of the uterine lining, it can make it harder for an embryo to implant successfully.
2. Affecting the Fallopian Tubes
Fibroids near the tubes may block or distort them, making it harder for the sperm and egg to meet.
3. Disrupting Uterine Contractions
The uterus has natural movement that helps sperm travel. Fibroids can sometimes disrupt this process.
4. Increasing Inflammation
In some cases, fibroids can create a less receptive environment for implantation.
None of this means pregnancy is impossible. It simply means the path may need a little more support.
Fibroids and Miscarriage Risk
Some fibroids, especially those that distort the uterine cavity, may increase the risk of miscarriage or early pregnancy loss. This is one of the reasons a detailed fertility evaluation matters. Understanding where fibroids are located helps determine whether treatment could improve pregnancy outcomes.
Do Fibroids Always Need Fertility Treatment Before Trying to Conceive?
No. This is one of the most important points: many fibroids do not require fertility treatment before pregnancy.
Fertility treatment depends on:
- Symptoms (pain, heavy bleeding, pressure)
- Fibroid size and location
- Your personal family-building goals
- Prior pregnancy history
Some patients are simply monitored. Others may benefit from surgical or medical treatment before trying to conceive. A personalized fertility evaluation helps avoid unnecessary procedures while still addressing anything that could affect fertility.
How Fibroids are Evaluated in a Fertility Assessment
If you’re trying to conceive and fibroids are part of your story, a fertility specialist may recommend:
- Pelvic ultrasound
- Saline sonogram (to look at the uterine cavity more closely)
- Hysteroscopy (direct visualization of the uterus)
- Fertility hormone testing if cycles are irregular
We use these tools to understand not just whether fibroids are present, but whether they’re actually affecting your ability to get pregnant.
Treatment Options If Fibroids Are Impacting Fertility
If fibroids are interfering with conception, there are several fertility treatment pathways depending on your situation:
Myomectomy (Fibroid Removal Surgery)
This is the most common fertility-preserving surgical option. It removes fibroids while keeping the uterus intact.
Medication Management
Hormonal therapies may help manage symptoms, but are usually not used long-term when trying to conceive.
Assisted Reproductive Technologies
If fibroids are not removable or not the primary barrier, infertility treatments like IVF may be recommended.
The goal is always the same: improve your chances of a healthy pregnancy while preserving your fertility options.
Fibroids and Pregnancy: What Happens if You Already Conceive?
Many people with fibroids go on to have healthy pregnancies. However, fibroids can sometimes increase the risk of:
- Pain during pregnancy
- Baby positioning challenges
- Preterm labor in certain cases
- Growth changes in fibroids due to pregnancy hormones
This is why early monitoring is important once pregnancy is achieved.
Fibroid Awareness Month: Why This Conversation Matters
Fibroids are common, manageable, and often compatible with fertility. The presence of fibroids does not automatically mean infertility. But it does mean you deserve clarity about whether they are playing a role in your fertility journey. That distinction matters. Because uncertainty is often the hardest part, not the diagnosis itself.
Fertility Care For Fibroids Across The Carolinas
We care for patients navigating fibroids and fertility across the region, including Charleston, Mount Pleasant, Greenville, Columbia, Spartanburg, Summerville, and Asheville.
As a leading fertility network in the Carolinas, we bring together reproductive endocrinologists with deep expertise in diagnosing and treating complex fertility conditions, including fibroids.
Our approach is simple: Understand your body. Identify what matters. Build a plan that fits your goals. No assumptions. No one-size-fits-all timelines. Just clear the next steps.
FAQs: Fibroids And Fertility
Can You Get Pregnant If You Have Fibroids?
Yes. Many people with fibroids conceive naturally and have healthy pregnancies. It depends on the fibroid size and location.
What Type Of Fibroid Is Most Likely To Affect Fertility?
Submucosal fibroids, which grow into the uterine cavity, are most likely to impact implantation and pregnancy outcomes.
Do Fibroids Always Need To Be Removed Before IVF?
Not always. If fibroids do not distort the uterine cavity, IVF may still be successful without surgery.
Can Fibroids Grow During Pregnancy?
Yes, some fibroids grow due to pregnancy hormones, while others stay the same size or shrink.
When Should I See A Fertility Specialist About Fibroids?
If you’ve been trying to conceive for 6–12 months without success, or you’ve been told you have uterine fibroids and are unsure of their impact, it’s a good time to get evaluated by a fertility specialist near you.
