Fibroids (also known as uterine fibroids or leiomyomas) are benign (non-cancerous) growths that develop from the muscle tissue of the uterus. They are one of the most common gynaecological conditions, affecting many women during their reproductive years.
Fibroids can develop within the wall of the uterus, inside the uterine cavity or on the outer surface of the womb. Some women have a single fibroid, while others may have several of different sizes.
The size of a fibroid can vary significantly. Some are only a few millimetres across and cause no symptoms, whereas others can grow much larger and may lead to pain, heavy menstrual bleeding or fertility problems.
Although hearing you have fibroids can be worrying, it's important to remember that most fibroids are harmless and many women with fibroids conceive naturally and go on to have healthy pregnancies.
At Manchester Fertility, we assess not only whether fibroids are present, but whether they are likely to be affecting your fertility or your chances of successful treatment.
of women of reproductive age may develop fibroids during their lifetime.
Of women experiencing infertility may have fibroids identified during fertility investigations.
Women with fibroids may experience symptoms such as heavy periods, pelvic pain, pressure, or fertility concerns.
The exact reason why fibroids develop isn't fully understood, but research suggests that a combination of hormones, genetics and lifestyle factors all play a role.
Fibroids are sensitive to the hormones oestrogen and progesterone, which help regulate the menstrual cycle. During the reproductive years these hormones can stimulate fibroid growth, while after the menopause fibroids often shrink naturally as hormone levels decline.
You may be more likely to develop fibroids if you:
Having one or more risk factors doesn't necessarily mean you will develop fibroids, and many women develop them without any obvious cause.
Not all fibroids affect fertility in the same way. Their location is often more important than their size.
Submucosal Fibroids grow just beneath the inner lining of the uterus (the endometrium) and often protrude into the uterine cavity. Because they can directly alter the shape and environment of the cavity where an embryo needs to implant, they are the type of fibroid most strongly associated with fertility problems.
Depending on their size and location, they may interfere with implantation, contribute to heavy or prolonged menstrual bleeding, or increase the risk of miscarriage. Even relatively small submucosal fibroids can sometimes have an impact because of their position within the uterine cavity.
Some fibroids may make it harder to access the ovaries for egg collection if they come in the way or if they displace the ovaries. This is assessed when scans are carried out for monitoring, then we may need to discuss your options.
Intramural fibroids develop within the muscular wall of the uterus, which is called the myometrium. They are the most common type of fibroid and can vary considerably in size. Their effect on fertility depends largely on their size and exact position. Smaller intramural fibroids that do not distort the uterine cavity may have little or no effect on fertility.
However, larger fibroids, particularly those that push against or distort the uterine cavity, may potentially interfere with implantation or alter the normal function of the uterus. They can also cause symptoms such as heavy menstrual bleeding, pelvic pressure, or pain.
Subserosal fibroids grow from the outer surface of the uterus, beneath the outermost uterine covering called the serosa. They generally grow outward, away from the uterine cavity, and therefore are less likely to interfere with fertility than submucosal fibroids directly.
In many cases, small or moderately sized subserosal fibroids do not affect the ability to become pregnant. However, very large fibroids can cause pressure on nearby pelvic organs, and their size or location may occasionally have an indirect effect on reproductive health. Their impact therefore depends more on their overall size and position than simply on the fact that they are subserosal.
Many women experience no symptoms at all and only discover they have fibroids during a fertility investigation or routine pelvic scan.
When symptoms do occur, they can vary depending on the size, number and location of the fibroids.
Common symptoms include:
In some cases, fibroids may contribute to anaemia due to heavy menstrual bleeding, causing fatigue, dizziness and shortness of breath.
If fibroids are affecting your fertility, difficulty conceiving may be the first symptom you notice.
Yes, but this depends largely on the type, size and location of the fibroid.
Many women with fibroids become pregnant naturally without needing treatment. However, some fibroids can make conception more difficult by changing the shape of the uterus, blocking the fallopian tubes or interfering with embryo implantation.
Fibroids may affect fertility by:
Submucosal fibroids are generally considered the most likely to affect fertility, while small fibroids on the outer surface of the uterus often have little or no impact.
Yes. Most women with fibroids are still able to conceive naturally and have healthy pregnancies.
Whether fibroids affect your chances of pregnancy depends on where they are located rather than simply how many you have.
Many women have small fibroids that never interfere with ovulation, fertilisation or implantation. Others may have larger fibroids that change the shape of the uterus or block the fallopian tubes, making conception more difficult.
Age also plays an important role. Fertility naturally declines as women get older, regardless of whether fibroids are present.
If you've been trying to conceive for more than 12 months (or six months if you're over 35), a fertility assessment can help determine whether fibroids or another fertility factor may be affecting your chances of pregnancy.
Our specialists will explain whether your fibroids are likely to require treatment or whether other fertility factors should be investigated first.
Fibroids are most commonly diagnosed using ultrasound imaging.
During your fertility assessment, your consultant may recommend:
These investigations allow us to accurately determine the number, size and location of any fibroids and assess whether they are likely to affect fertility or pregnancy.
Small fibroids that are not affecting fertility may simply be monitored.
Submucosal fibroids inside the uterine cavity can sometimes be removed using a minimally invasive procedure through the vagina and cervix.
A myomectomy removes fibroids while preserving the uterus. It may be considered for women wishing to become pregnant, although the benefits depend on fibroid type and individual circumstances.
This may be done through Open surgery or laparoscopy (including robotic)
Some fibroids can reduce the success of IVF treatment, while others have little or no effect.
Fibroids that distort the uterine cavity are more likely to interfere with embryo implantation and may reduce pregnancy rates or increase the risk of miscarriage.
Small fibroids located within the muscle of the uterus or on its outer surface often do not significantly affect IVF outcomes, although every case is different.
Before recommending IVF, your fertility consultant will carefully assess whether removing a fibroid is likely to improve your chances of success. In many cases, IVF can proceed safely without surgery.
Treatment decisions are based on the latest evidence and tailored to your individual fertility history, age and treatment goals.
Our experienced fertility specialists understand the complex relationship between fibroids and fertility.
When you choose us, you'll benefit from:
Yes. Many women with fibroids conceive naturally. The impact depends on the location and size of the fibroids rather than simply their presence.
Fibroids are not always the cause of infertility. However, fibroids that affect the uterine cavity or significantly alter the uterus may reduce fertility chances.
Usually not during IVF itself. If removal is recommended, it is generally planned before fertility treatment begins.
New fibroids can develop after treatment because myomectomy removes existing fibroids but does not prevent future growth.
The recommended timeframe depends on the type of surgery and individual healing. Your specialist will advise based on your circumstances.
Not necessarily. Many women with fibroids conceive naturally without any difficulty. Whether fibroids affect fertility depends on their size, location and number. Fibroids that distort the inside of the uterus are more likely to interfere with conception than those growing on the outside of the womb.
Submucosal fibroids, which grow into the uterine cavity, are considered the type most likely to affect fertility because they can interfere with embryo implantation and increase the risk of miscarriage. Intramural fibroids may also have an impact if they are large or distort the uterine cavity, while subserosal fibroids are less likely to affect fertility.
It depends on the type, size and location of your fibroids. If fibroids are affecting the uterine cavity or causing symptoms that may impact fertility, surgical removal may improve your chances of conception. However, not every woman with fibroids will benefit from surgery, and your fertility specialist will assess whether treatment is appropriate for your individual circumstances.
Some fibroids, particularly those that alter the shape of the uterine cavity, have been associated with an increased risk of miscarriage. However, many women with fibroids experience healthy pregnancies, and the overall risk varies depending on the characteristics of the fibroids and other individual factors.
The only way to determine whether fibroids are affecting your fertility is through a comprehensive fertility assessment. This may include an ultrasound scan, hysteroscopy, MRI scan or other investigations to assess the size, location and impact of the fibroids on the uterus.
Speak to one of our friendly co-ordinators to find out exactly which type of fertility testing option suits you.
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