Understanding Infertility and Fibroids

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Dr Aparna N
 Understanding Infertility and Fibroids

When lumps grow in the uterus they are diagnosed to be Uterine fibroids. The uterus is the most vital organ in a woman’s body, that facilitates the growth of the embryo when she achieves pregnancy. Uterine fibroids are generally diagnosed as non-cancerous growth but they are considered to leave a significant impact affecting a woman's fertility. These Uterine fibroids are most commonly diagnosed among women who fall between the ages of 30 and 40. There are times when fibroids could be tiny and hence unable to be detected; however, as they grow bigger in size, they end up causing several issues that lead to infertility.

Understanding the connection between these growths and fertility is an important factor for any woman who is interested in starting or further expanding her family. Fibroids are a common issue that is of late affecting about 70-80% of women at some point in their lives.

Fibroids are also called fibromyomas or myomas. They develop as benign or noncancerous, muscular tumors or growth. These fibroids could either grow inside your uterus or on its outer surface or the uterine wall. With time, the size of the fibroids can range from being as small as a seed to as large as a melon.

While there is no single cause determined for fibroids; however, the condition is linked to genetics or hormonal factors related to levels of estrogen and progesterone. The condition is also linked to changes in the extracellular matrix (ECM), which is the material that helps cells stick together.

As mentioned earlier, uterine fibroids can vary in size and number and can be located on the inside, outside, or within the uterus muscle wall.

The Symptoms of Uterine fibroids

The reason behind these fibroids is yet to be known. Women with Uterine fibroids have problems such as pain in the belly, Other common symptoms of fibroids that a woman may experience include:

• Ongoing heavy menstrual cycles that do not quit.

• Feel heaviness such as carrying a bowling ball in your belly.

• Constant pressure on the bladder.

• Pain during sexual intercourse.

• Having trouble getting pregnant.

• Anemia was diagnosed due to blood loss.

• Pelvic pain or pressure.

• Lower abdominal swelling or bloating.

• Constipation or frequent urination.

How do fibroids affect your body?

• There are many factors that can interfere with a woman’s ability to conceive and give birth to a healthy baby. The impact of Uterine fibroids on your fertility is related to the way these benign tumors affect those parts of the uterus that support healthy conception, pregnancy, and delivery.

• Studies suggest that fibroids usually develop during your childbearing years when your estrogen levels are highest. Up to 30% of all women are affected by fibroids by age 25, while up to 80% of women develop fibroids by age 50.

• While you may have fibroids without any symptoms, the condition often causes lower back pain, painful sex, and pelvic pressure. Fibroids are also associated with symptoms so severe such as painful menstrual cycles that they disrupt your daily life with, frequent urination, heavy bleeding between menstrual cycles, and trouble voiding.

How do fibroids change fertility?

It is diagnosed that most women with fibroids are not infertile. While Uterine fibroids exist in 5-10% of infertile women, it is most likely to be the primary cause of infertility in less than 3%. Fibroids can interfere with fertility in the following ways:

Blocked fallopian tubes

• Make it difficult or highly impossible for a fertilized egg to travel to the uterus and successfully implant

• Change the shape of your cervix, which can reduce the number of viable sperm that reach the uterus and/or prevent the movement of sperm or the successful implantation of a fertilized egg

• Thicken the uterine lining that interferes with successful implantation

Causes change to the blood flow

• The uterine cavity, which can affect implantation While having uterine fibroids can also interfere with your ability to have a healthy pregnancy and delivery, during pregnancy women can also have a higher risk of pregnancy complications and problems with delivery.

• Furthermore, the size and location where some tumors are placed can have an impact on the baby leading to an abnormal placement or position that can trigger pain, cause placental abruption which is premature separation of the placenta from the uterus, and lead to miscarriage, or preterm labor.

The diagnosis of uterine fibroids typically involves the below-mentioned steps:

• Medical history and physical examination: Your past medical history will be referred to. In addition to this, your symptoms, menstrual cycle history, and generic or family history of fibroids will be considered. Also, a physical examination will be performed to look out if any abnormalities are present in the uterus.

• Ultrasound: An ultrasound is a non-invasive test performed that utilizes high-frequency sound waves to create various images of the uterus. This test is performed to detect the size, number, and location of fibroids. As ultrasound does not expose the patient to ionizing radiation, it makes it a safe option for pregnant women or those trying to conceive.

• MRI: Magnetic Resonance Imaging (MRI) is a more advanced test that makes use of strong magnetic fields and radio waves to create various images of the uterus and fibroids.

• Hysteroscopy: A minimally invasive procedure in which a thin, lighted scope is inserted through the cervix to view the inside of the uterus is called hysteroscopy. This procedure ascertains the presence of fibroids and helps determine the best treatment options available.

• Laparoscopy: A minimally invasive surgical procedure used to diagnose and treat uterine fibroids is called laparoscopy. This procedure involves inserting a thin, lighted scope through small incisions to visualize the uterus and fibroids. It provides a more accurate diagnosis and determines the best course of treatment.

Treating fibroids

When uterine fibroids cause extreme pain, medical practitioners may prescribe one of several medications to relieve your symptoms.

In case you have large or multiple fibroids that interfere with your fertility, you may benefit from minimally invasive treatments, or surgery performed to shrink or remove fibroids without causing any damage to your uterus.

When fibroids affect fertility, doctors will determine the most effective method for treating the condition thus improving the chances of conception. Treatment options available for uterine fibroids include medicines, surgery, or a combination of both.

Additionally, you would need to monitor your symptoms. If you continue to have symptoms of uterine fibroids, such as heavy or prolonged menstrual cycles, pelvic pain, pelvic pressure, or difficulty getting pregnant, it is highly essential to consult a healthcare professional without further delay for proper diagnosis and go ahead with the treatment options if necessary.

To conclude, it is important to note that fibroids can impact fertility and could lead to problems with implantation or increase the risk of miscarriage. Hence, early and timely consultation and detection of the cause and treatment of fibroids can help improve the chances of conception and thereby assist successful pregnancy.

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