fibroids & Infertility

Fibroids and infertility: Is there a relationship?

 Terseer Adamu (Review) 27/06/2031

Fibroids are very common. Up to 40 per cent of women over 35 years of age have fibroids. Although many of these women will have no symptoms at all, experts say that depending on the number, size and location of the fibroids, this can cause a woman to have trouble achieving successful pregnancy, reports Sade Oguntola.

Three years after giving birth to her son, Hannah began to experience abdominal pain and heavier bleeding with each monthly period. At the hospital, the medical doctor performed a routine pelvic examination and discovered she had a fibroid.

As time passed, Hannah’s menstrual flow became so heavy she changes her sanitary towel every other hour. When menstruating, she dare not leave her home for fear of a blood gush that might leave her dress strain badly. Within nine months, she was anaemic and in desperate need of medical care to put a stop to the problem.

Fibroids are overgrowths of tissue in the uterus or womb. They grow from the muscle that constitute the wall of the womb and are not due to cancer. Up to 40 per cent of women over 35 years of age have fibroids, but it can develop at any age.

In some women, fibroids cause few symptoms and may go unnoticed. In others, they can cause symptoms so severe, that their entire quality of life is compromised.  

Generally, its symptoms include heavy and prolonged menstrual periods, bleeding in between periods, abdominal and lower back pain, frequent urination, constipation and, in rare cases, miscarriage and infertility.

Majority of women who have fibroids will get pregnant with no problem, and the majority of women who have fibroids will see the pregnancy through with no problems. However the diagnosis of fibroids may in itself be a “wake up” call to the possibility such women experiencing difficulty getting pregnant and problems during pregnancy.

There are several ways in which fibroids may affect pregnancy. According to Professor Oladapo Ashiru, Medical Director, Medical Art Centre, Maryland, Lagos, “when the fibroid is inducted in the muscle of the uterus (womb), not inside the womb where the baby is supposed to develop and it is less than 4 cm, you can have a baby within.

“But once the fibroid is above 4cm and it is inside the womb (cavity), you have to remove it before the woman can conceive. This is because the fibroid is projecting inside the womb cavity.”

Although a woman may have multiple fibroid growths, he stated that once these were on the wall of the womb and not inside the womb, a woman can conceive.

But the sizes of the fibroids and their precise location within the womb are likely to be important factors in determining whether or not the fibroids will affect the pregnancy, labour and delivery.

The presence of fibroid can also increase the risk of pregnancy complications, which includes bleeding in early pregnancy, abnormal position of the baby, some challenges in labour, especially where the fibroid is blocking the lower part of the womb. It has also been associated with increased risk of operative delivery and increased bleeding after delivery.

Professor Ashiru who linked the growth of fibroid to excessive consumption of oestrogen substances such as Vitamin E, royal jelly and some oily foods, said “consumption of excess fats eaten can be converted into oestrogen, which helps fibroid grow.”

The expert, however, assured that women with fibroid can be helped if they seek treatment from qualified health practitioners, adding that because often women have no symptom of fibroids, many women with fibroids do not know they have them.

Aside the fibroid contributing to cases of infertility, he stated that multiple fibroid could also result in difficulty having a bowel movement or pain with bowel movements. When fibroids press against the rectum, this could result in difficulty having a bowel movement or pain with bowel movements.