Fibroids are common — around 20–30% of women of reproductive age have them — and one of the first questions women ask after a diagnosis is whether fibroids are the reason they are not conceiving. The honest answer is: sometimes, but not usually. Whether fibroids affect your fertility depends mainly on where they grow and how big they are. This article explains the types of fibroids, the symptoms they cause, which ones matter for fertility, and what can be done.
🦋 Quick answers
- What are fibroids? Non-cancerous growths in the muscular wall of the uterus (also called leiomyomas).
- Do all fibroids affect fertility? No. Location and size matter most — submucosal fibroids (inside the cavity) and large intramural fibroids (over 5cm) are the ones most associated with fertility problems.
- How common are they? An estimated 20–30% of women of reproductive age, and 5–10% of women with fertility problems.
- Do fibroids always need treatment? No. Many need no treatment at all. The decision depends on your symptoms, the fibroid’s size and position, and your fertility plan.
What are fibroids?
- Fibroids are also known as leiomyomas.
- They are non-cancerous (benign) growths that develop in the muscular layer of the uterine wall.
- An estimated 20–30% of women in the reproductive age range have fibroids, and 5–10% of women with fertility problems have them.
- Many women have no symptoms at all — fibroids are often found during a routine pelvic ultrasound.
The three layers of your uterine wall
- Endometrium — the innermost layer. A fertilised egg implants here. If pregnancy does not occur, this layer sheds as your period.
- Myometrium — the middle layer, made of muscle that expands and contracts.
- Perimetrium — the outer protective layer of the uterus.
Fibroids grow in the myometrium (the muscle layer), which is why their position in the wall determines the symptoms they cause.
What symptoms can fibroids cause?
Symptoms depend on the fibroid’s size, number and position. Many women have none at all. When symptoms do occur, they may include:
- Heavy or prolonged menstrual bleeding
- Period cramps or pelvic pain
- Pressure symptoms — needing to pass urine often, a bloated feeling, or pressure on the bowel, depending on which direction the fibroid presses
- Fertility problems
- Problems during pregnancy, including miscarriage, abnormal fetal position and bleeding during delivery
Where do fibroids grow — and which type affects fertility?
- Subserosal (55%) — outer layer of the uterine wall. Least likely to affect fertility.
- Intramural (45%) — middle muscle layer. Matters most when large (over 5cm) and when it changes the shape of the uterine cavity.
- Submucosal (5%) — the innermost layer, projecting into the cavity where an embryo needs to implant. Most strongly linked to fertility problems.
Large intramural fibroids (over 5cm) that distort the shape of the uterus, and submucosal fibroids, tend to cause more problems than subserosal fibroids.
Do fibroids cause infertility?
Fibroids can contribute to infertility, but they are less often the cause than many people assume. The American College of Obstetricians and Gynecologists (ACOG) notes that fibroids may cause infertility, but that other causes are more common — and other factors should be investigated before fibroids are assumed to be the reason.
When fibroids do interfere, it is usually because they:
- distort the uterine cavity and interfere with implantation (submucosal fibroids),
- change the blood supply or environment of the lining where the embryo must attach (large intramural fibroids), or
- block the fallopian tube opening in some positions.
How are fibroids diagnosed?
Most fibroids are found on a pelvic ultrasound scan. If the scan shows fibroids and you are trying to conceive, your doctor will assess their size and position, and check whether there are other possible causes of infertility that need attention first — such as ovulation problems, blocked fallopian tubes or sperm factors.
What are the treatment options?
Treatment depends on the size and position of the fibroids, your symptoms, and your fertility plans. Options range from simply monitoring fibroids that cause no problems, to medication for symptoms such as heavy bleeding, to surgery (myomectomy) to remove fibroids when they are likely to interfere with conception or pregnancy. Your doctor will discuss which option suits your situation — there is no single answer that fits everyone.
Frequently asked questions
Are fibroids cancer?
No. Fibroids are benign (non-cancerous) growths. They are not cancer and they do not turn into cancer — although any pelvic growth should always be assessed properly by your doctor.
Can I get pregnant with fibroids?
Yes — many women with fibroids conceive without difficulty, especially if the fibroids are subserosal or small. If you are not conceiving, it is important to check for other causes as well, because fibroids are often not the reason.
Do all fibroids need to be removed before IVF?
No. Removal is considered when a fibroid is likely to interfere with implantation or pregnancy — particularly submucosal fibroids or large intramural fibroids that distort the cavity. Your fertility specialist will advise based on your scan and history.
Can fibroids come back after surgery?
New fibroids can develop over time, so follow-up is important — especially if you are planning a pregnancy. Talk to your doctor about what follow-up suits you.
Related reading
- Fibroid dan Fertiliti Anda (Bahasa Melayu)
- Fertility tests for couples: what to expect
- More on fibroids and fertility
Sources
- American College of Obstetricians and Gynecologists — Uterine Fibroids (FAQ)
- ASRM ReproductiveFacts — Fibroids and Fertility fact sheet
- Michos G, et al. Uterine Leiomyomas and Infertility, 2023
