Uterine fibroids and fertility

General Information

The name of this condition can cause anxiety in many patients. However, modern gynecologists and obstetricians are well aware of its nature and have the necessary diagnostic and treatment methods. Leiomyoma is most common in women of reproductive age, peaking at 30-35 years, but it can also appear during menopause. It is the most frequent benign tumor of the female reproductive system.

Is uterine fibroid a frightening diagnosis?

Uterine fibroid (also known as leiomyoma, myoma, or fibroid) is a benign tumor formed from the muscular layer of the uterus (myometrium) and connective tissue. Its growth depends on levels of sex hormones, particularly estrogen.

It is important to understand that myoma is not a disease, but its location can lead to consequences for fertility, urinary infections, etc. Ignoring symptoms and delaying treatment can lead to complications.

Here are three essential reasons explaining the importance of a quick diagnosis:

• The fibroid is very rarely the cause of infertility (2 to 3% of cases), but it can affect fertility and make pregnancy difficult.
• The malignancy of the myoma is rare, but the tumor can reach sizes of 20 to 30 cm and significantly deteriorate quality of life.
• Nodes often develop asymptomatically, but in the most severe cases, they may require the removal of the uterus.

Types of fibroids:

The fibroid consists of one or more nodules, which is why it is also called fibromatous. The modern name for the disease is leiomyoma. Depending on its location, the following types of nodules are distinguished:

• Submucosal nodule - located in the uterine cavity, it causes heavy menstruation and uterine bleeding. Often associated with the uterine factor of infertility.
• Intramural nodule - located within the thickness of the muscular wall of the uterus.
• Subserosal nodule - develops on the external surface of the uterus and may extend into the abdomen.

Causes and risk factors

The exact causes of leiomyoma are not established, but the following risk factors have been identified:

• Hormonal disorders;
• Obesity;
• Absence of pregnancy, childbirth, and breastfeeding;
• Hereditary predisposition;
• Chronic inflammatory processes;
• Induced abortions.

Symptoms of fibromatous nodules

Early signs

In the initial stages, you may experience

• general weakness and dizziness
• Pain in the lower abdomen and lower back;
• Heaviness in the lower abdomen, frequent urination (due to pressure on the bladder);
• Constipation (due to pressure on the rectum);
• Prolonged periods (up to 9-11 days);
• Spotting between cycles.

Signs of complications

As the disease progresses, there may be:

• severe abdominal pain;
• Menorrhagia (heavy and prolonged periods), bleeding;
• Anemia (hemoglobin may drop to 60 g/l), a blood transfusion may be necessary;
• Excretion of fragments of pathological tissues with menstruation;
• Pregnancy difficulties;
• Risk of malignancy (requires ultrasound, MRI, histology).

Effect on pregnancy

Possibility of pregnancy in the presence of fibroids

Small nodes do not always interfere with the onset and progress of a pregnancy. In each case, the decision is made individually by a gynecologist or reproduction specialist.

Risks associated with large fibroids

Large submucosal myomas can

• prevent the implantation of the embryo
• cause miscarriages or blocked pregnancies;
• cause disturbances in the blood supply to the fetus and placental abruption.

Before planning a pregnancy, it is necessary to undergo a complete examination, including an ultrasound, and, if necessary, surgically remove the fibroids.

If pregnancy has already occurred

In the presence of nodules, the doctor's responsibility is to preserve the pregnancy. Modern treatment methods allow most women to carry and give birth to a healthy child.

Diagnosis of fibromatous nodules

When to see a doctor?

Even in the absence of pronounced symptoms, it is important to consult a gynecologist, especially in cases of:

• Atypical menstruation;
• Pain in the lower abdomen;
• Pregnancy difficulties.

Women considering pregnancy or IVF should have the endometrium and uterine cavity evaluated. This includes basic protocols:

• IVF (in vitro fertilization) - classic method of fertilization outside the body followed by embryo implantation;
• IVF with donor eggs - used if your own oocytes are absent or unsuitable;
• IVF with double donation - donor eggs and sperm are used in cases of infertility in both partners.

Diagnostic methods

• Collection of medical history, evaluation of symptoms;
• Ultrasound of the pelvic organs - primary diagnostic method;
• MRI, CT - allow a detailed assessment of the structure of the uterus and the prevalence of nodules;
• Histology - analysis of the nodule that is taken in case of suspicion of a malignant process.

Regular examinations and early diagnosis help prevent complications and preserve the reproductive health of women.