4. "Fibroids were found on my ultrasound—what now?"
With all that we as women have to juggle, our reproductive health is often a sensitive issue, especially when it comes to pregnancy. Not only are we incessantly reminded of our "biological clocks ticking" but many women who desire children face other potential barriers and health concerns that may impact their ability to conceive. One such issue is uterine fibroids and their potential impact on pregnancy.
It may help to know that fibroids, which are tumors that grow in the wall of the uterus, are very common and are almost always benign. Most women with fibroids have normal pregnancies, but there are some cases where fibroids may cause complications during pregnancy and delivery, or while trying to conceive. As always, your first step should be to discuss fibroids with your doctor.
Here are answers to some common questions about fibroids and pregnancy.
I have fibroids—does this mean I can't get pregnant?
Many women CAN successfully conceive and carry to full term despite being diagnosed with fibroids. But it's also true that some women experience infertility and recurrent pregnancy loss due to fibroids. It is important to discuss with your doctor where in your uterus the fibroid(s) are located. Depending on their location, some fibroids may increase the likelihood of miscarriage, as the pregnancy does not have a good place to implant. If fibroids are suspected, your doctor will likely order an ultrasound for further evaluation.
Do I need to have surgery for fibroids?
Surgery is NOT always needed in the case of fibroids. Some fibroids are very small and asymptomatic. Surgery is often reserved for patients who have symptoms such as pain, heavy bleeding, problems with urination or any combination of the above. If fibroids are found in the cavity of the uterus of a woman being evaluated for infertility and/or recurrent pregnancy loss, it is usually recommended that the fibroids are removed in order to increase odds of successful conception.
I’ve had fibroids removed in the past. Can I get pregnant?
Yes! Women who have had previous fibroid removal, known as a myomectomy, can get pregnant. It is important to discuss with your doctor how soon after surgery it is safe to start trying to conceive. Your body needs adequate time to heal prior to carrying a pregnancy. Once pregnant, depending on the nature of your previous surgery, it may be necessary to deliver a few weeks before your due date by Cesarean section. If your current doctor did not perform your fibroid surgery, they may request records to determine exactly how your fibroids were removed. Then your doctor can counsel you appropriately on the timing and mode of delivery.
I just found out that I’m pregnant, and fibroids were found on my ultrasound—what now?
Fibroids are extremely common so all are not cause for concern. Depending on their size and location there may not be much to do. Usually if a woman has fibroids and is pregnant, she will undergo ultrasounds throughout the pregnancy. Fibroids can sometimes grow during a pregnancy and if large enough they can potentially impact the baby's growth. Ultrasounds will allow for the monitoring of baby's growth as well as that of the fibroid. Additionally, fibroids occasionally undergo the process of degeneration during a pregnancy, which can be very painful. Your doctor may prescribe a medication to help alleviate your symptoms.
While pregnancy with fibroids can feel complicated or challenging, remember that you are not alone—and that fibroids are a common condition. Talk to your doctor about your concerns.
A version of this post appeared on Dr. Kiarra King's website.
The American College of Obstetricians and Gynecologists, Uterine Fibroids, June 2020.
Center for Uterine Fibroids, Brigham and Women's Hospital, About Uterine Fibroids,
U.S. Department of Health and Human Services, Office on Women's Health, Uterine Fibroids, April 2019.