Unfortunately 20-40% of women of childbearing age may have uterine fibroids which can lead to questions about pregnancy. The location and size of a fibroid can affect a woman’s fertility. Studies have shown a fibroid measuring over 6 cm in diameter or within the uterine cavity can decrease the chances of pregnancy by up to 70%. There are numerous possibilities why uterine fibroids can affect pregnancy.
- Fibroids can block the fallopian tubes
- Fibroids can change the shape of the uterus interfering with the movement of
sperm or an embyro
- Fibroids can change the amount of blood flow to the uterine cavity decreasing
the ability of an embryo to implant itself or grow
- Fibroids can change the shape of the cervix affecting sperm entering the uterus
Your doctor may discuss the treatment options between myomectomy (fibroid removal) or uterine fibroid embolization (UFE). There may be misinformation regarding UFE in these situations, and patients may be told they are not candidates and surgery is their only option.
Having a healthy pregnancy and delivery are both possible after uterine fibroid embolization. A study in 2017 investigated 359 women with uterine fibroids unable to become pregnant who then underwent UFE and followed up for an average of 6 years. During that followup period, 149 women (41.5%) became pregnant at least once and 131 women gave birth to a total of 150 babies. It was the first pregnancy for over 85% of these women. Of the women with unsuccessful pregnancies, miscarriage was the most common reason. The study concluded that UFE can be a safe option for women with fibroids as a treatment option that restores fertility.
Another study in 2017 published in the International Journal of Biomedicine showed that the frequency of pregnancy and delivery complications among women who have had UFE for fibroid treatment was not significantly different from healthy women without fibroids. Therefore the researchers reiterated that UFE is not a contraindication for pregnancy and childbirth and that UFE is a “highly efficient alternative to surgical or medical treatments for uterine fibroids in patients of reproductive age, who plan on pregnancy”.
It is important to be well informed and know all your options, including the benefits and risks of each treatment option by discussing it with experts who perform the actual procedures.