Do fibroids affect fertility?
If the desire to have children does not come true for a long time, a fibroid can be a cause. About 25% of women over the age of 30 have such a uterine tumor. The benign tumor in or on the uterus can disrupt menstrual cycles and increase the risk of premature birth or miscarriage. Here we provide information on what exactly a fibroid is, what symptoms it causes and how it can be treated.
What is a fibroid?
A fibroid is a muscle tumor in or on the uterus. The hormone-dependent tumor develops from the muscle cells of the uterus under the influence of estrogen. Its growth is therefore directly related to the function of the ovaries, which is why a fibroid can only form during sexual maturity and occurs mainly in women between the ages of 30 and 40. Fibroids are the most common benign tumors of the female reproductive organs, affecting one in four to six women of childbearing age in Europe. Despite this frequent occurrence, the causes of the development of fibroids are not known to this day.
Fibroid: symptoms and signs
Depending on the size and location of the fibroid in the uterus, different symptoms or symptoms can occur. About a quarter of those affected have no symptoms at all and the fibroid does not affect their quality of life. This is often the case with a very small knot.
- With a fibroid inside the uterus , the most common symptom is a disruption in the menstrual cycle. This can manifest itself as heavy or irregular bleeding or frequent bleeding between periods. If you want to have children, an irregular cycle can disrupt conception, which is why the fibroid should definitely be treated in this case.
- A fibroid located in the area of the fallopian tube can affect fertility. It is true that conception is very rarely prevented by fibroids. However, due to the foreign body sensation within the genitals, they cause an increased willingness to labour, which can increase the likelihood of premature birth or miscarriage .
- If a fibroid is on the outside of the uterus , other internal organs, such as the rectum or urethra, can be affected, depending on its size and location. Frequent urge to urinate or constipation can also be a sign of a fibroid.
Furthermore, fibroids can manifest themselves through pressure or a foreign body sensation in the abdomen, cramp-like menstrual cramps, low back pain or problems during sexual intercourse. Under certain circumstances, fibroids can also cause kidney diseases. If one of the symptoms occurs, the gynecologist should therefore be consulted in order to find the cause of the symptoms.
How is a fibroid diagnosed?
A fibroid is often discovered by chance during a general gynecological routine examination, since many of those affected do not have any symptoms. In most other cases, based on the symptoms described above, a targeted search is made for the presence of a fibroid.
- For this purpose, the gynecologist first conducts a preliminary talk in order to be able to rule out any previous illnesses that could alternatively be responsible for the symptoms described.
- This is usually followed by a palpation of the uterus . Larger fibroids can be easily diagnosed in this way.
- Since the palpation examination is not very reliable for small or hidden fibroids, the gynecologist also carries out an ultrasound examination . This is done vaginally so that fibroids located inside the uterus can also be detected.
- Depending on the location and extent of the fibroid, a uterine or laparoscopy may also be necessary to better assess whether the lump should be treated or removed.
treatment of fibroids
In the past, a fibroid was often removed by removing the entire uterus. Today, non-surgical methods are generally used, especially in young women, to preserve the uterus and continue to make it possible to have children. Only if a large number of fibroids are found in the uterus does the entire organ have to be removed in some cases. The type of treatment for a fibroid today depends on several factors. This includes both the type of symptoms that occur and the location and size of the fibroid, the age of those affected and their family planning. The period of infertility, the waiting and the treatment are not only a physical challenge. How couples can best survive this difficult time, we have in our article “Coping with a lack of pregnancy as a couple ” summarized.
- Hormonal treatment : Since fibroids develop in a hormone-dependent manner, they can usually be treated well with hormonal therapy. The affected person takes antiestrogens or progestins, which shrink the fibroid over time. This hormone therapy is primarily used in older patients shortly before menopause, since the menstrual cycle is down-regulated and the fulfillment of an existing desire for children in younger women would thus be prevented.
- Embolization : Embolization is a minimally invasive procedure. A catheter is inserted through a small abdominal incision into the uterine artery, which supplies blood to the fibroid. Small plastic beads are then injected into the artery via the catheter, which interrupt the blood flow. The fibroid undergoes a kind of “collapse”, shrinking significantly within a month after the procedure and symptoms are relieved.
- MRI-guided focused ultrasound : With this treatment method, the tissue that makes up the tumor is destroyed by using targeted ultrasound waves. Images from the magnetic resonance tomograph (MRI) are used for the exact localization of the fibroid, with the doctor treating you focusing the sound waves on a specific point. However, this treatment is only used for tumors less than eight centimeters in size.
A fibroid can express itself in very different ways and therefore the treatment also depends on the individual situation of the respective patient. Thorough care and advice from the gynecologist is therefore very important.
Also, treatment is not necessary in all cases . For example, if a diagnosed fibroid does not cause any symptoms, removal is not absolutely necessary. In such a case, however, regular monitoring of the development process is the top priority. Although fibroids are usually benign nodules, in rare cases malignant degeneration is possible. Even symptom-free patients should therefore be examined by a gynecologist at quarterly to six-monthly intervals in order to be able to act quickly in the event of a negative development.