Can fibroids stop implantation?

Fibroids are one of the pathologies that can be seen inside the uterus. It is a B9 growth that happens inside the muscle of the uterus. Most of the time, it’s an overgrowth of the smooth muscles, fibroids end up to be tough or so. They are not soft to touch, they are quite hard, they might interfere with fertility. They might interfere with fertility depending on their place and their size, mainly if they are present underneath the lining or if they are very large inside they might interfere with fertility. Mainly they interfere with implantation issues, so they might prevent embryos from implanting or they might also interfere, depending on their position and size, they might also interfere with pregnancy itself. By that I mean they might increase (again, based on their size and position) they might increase a little bit the miscarriage rate. They might be associated with sometimes first trimester spotting or bleeding as well. You will need to discuss the presence of fibroids with your doctor. I repeat – not every fibroid needs to be taken out but the risks and the benefits need to be weighed and based on that the decision will be taken in order to choose a treatment that is not going to jeopardize success rate, yet it’s not going to put you at a high risk during the operation.

Two categories of fibroids or precise two situations when the fibroids can be dangerous in fertility patients. Of course the first one will be: submucous fibroids when the fibroid is growing in the uterus in the cavity where the baby should be – in that cases it could have of course repeated implantation failure so the patient does not become pregnant or sometimes she becomes pregnant and then loses the pregnancy – that is one situation. The second situation is when the fibroid is not in the cavity but is in the thickness of the endometrium in the uterine wall. In that cases when it is very big so over 4-5 centimeters we should take it into consideration because sometimes pregnancy can begin and then it could be stopped or patient could abort or patient could have problems with prematurity because the fibroids at the beginning of the pregnancy grow very fast and they could arrive to 8-9 centimeters.
Let’s keep in mind that submucous fibroid can be taken out – that is for sure. Fibroid in the uterine wall that up to 3-4 centimeters we can leave it, over 4 centimeters it should be taken out, it should be operated as it could cause problems in fertility but mainly in pregnancy.

Well, there’s a couple of questions here and the first is kind of to outline what kind of fibroids you can have. Again, fibroids in essence are overgrowth of the muscle of the womb, in a certain kind of tissue within the muscle of the womb and they’re really, really common. They can be on the outside of the womb and they’re called subserosal. They can be within the muscle of the womb and they’re called intramural or they can be within the inside impacting on the lining of the womb and those are submucosal. Those lateral ones, the submucosal ones, that in essence is sitting in the womb where an embryo is going to want to implant – that are the ones that are particularly shown to impact on fertility and those are the ones that are most easy to remove with using hysteroscopy sounding a little look inside the womb with a camera and you can very easily remove those. Those are the ones that are key really to remove. With the other ones, there’s a little bit of evidence that big ones within the muscle, could impact on outcomes but there’s no great evidence that removing them surgically actually improves the outcome and it’s a significant surgical procedure. In most cases, you’d leave those alone – it’s just the ones, the submucosal ones, that come into the lining of the wound that we would have impact on – that we would recommend surgery.