If you have fibroids, you may worry about future pregnancy. Uterine fibroids aren’t usually cancerous, which is good news. But they grow in your womb, and they’re very common during your reproductive years. Fibroids develop as single tumors or as multiple growths. Depending on the type, size, and number of fibroids you have, they could affect your pregnancy.
Recently, Greenleaf star Deborah Joy Winans announced her pregnancy after a fibroids journey. Just a year before announcing her pregnancy, Winans’ doctors discovered she had eight large fibroids. While she was considering her treatment options, she also learned she was pregnant.
Right away, she learned this could be a problem. Winans told Essence magazine, “When [the doctor] started to tell me the things that will happen in my body because of the fibroids and the things that the baby might face, I just was like, ‘Okay, this is really, really serious. ”
Just months later, Winans wound up in the ER with terrible pain and vomiting. There, she learned that degenerating fibroids were responsible for her misery. Next, she needed a surgical procedure to close her cervix, which was opening too soon. Following that procedure, bed rest was in order. So, today she says she’s simply hoping to carry her baby closer to her due date. “As long as I can get to 28 [weeks]… [my doctor] knows that [the baby will] be good and healthy if he came that early. So, 28 is the goal.”
Of course, delivering her baby isn’t ideal. But pre-term labor isn’t the only way fibroids affect pregnancy. In fact, studies suggest, they could also impact your health in ways that don’t involve your growing fetus.
July was National Fibroid Awareness in several cities and states, and Houston has joined that group now, which is something we’re very excited about. So, in recognition of her efforts, we honor Tamika Gray Valburn, founder of The White Dress Project. For years, Tanika suffered with fibroids. Her mom lost two sets of twins because of her own fibroids. But even with the family history, Tamika didn’t make the connection to her own diagnosis!
In fact, Valburn’s fibroids were diagnosed in her late teens. At that point, she’d experienced years of painful symptoms. “You just think it will skip a generation,” she’s explained in interviews. “When you’re young, you’re not thinking it will be your story as well.” But, like so many women, Valburn discovered that fibroids do tend to run in families.
Living with Fibroid Symptoms
Because Valburn’s fibroids triggered heavy periods, she “learn[ed] how to pad myself [to keep from leaking through clothes.] I know the whole formula—what kind of underwear to wear, what kind of tights, what kind of Spanx. I’ve tried and tested everything. It’s become a way of life.”
Eventually, Tanika surgically removed 27 fibroids from her uterus. After her recovery, she wanted to help other women. So, in 2014, Tanika earned a Georgia state representative’s support in declaring July as Fibroid Awareness Month. The goal? Helping women get the crucial health information they need.
But she didn’t stop there. Tanika realized that she never bought white clothing. She said, “It’s a simple thing. Like, who cares, why not just wear black? But I love clothes, and the fact that I had to sacrifice wearing white for these benign tumors—I wasn’t feeling it.”
The White Dress Project
That same year, Tanika founded the White Dress Project, a nonprofit organization dedicated to promoting fibroid awareness, supporting research, and bringing together a community of women who work to empower one another. After all, this is crucial. According to the CDC, one in three women will have a hysterectomy by the time she turns 60. But, according to the American Journal of Obstetrics and Gynecology, 18.3% of those hysterectomies aren’t medically necessary. So, why do women have these surgeries? They don’t know about other options!
That’s where Tanika and her project want to make a difference. And they’ve made white dresses their symbol, as it signified a major milestone in Tanika’s recovery: the moment she could rock a white dress without any fear. (Because minimally invasive surgery helped resolve her painful fibroid symptoms.) Now, the white dress has become a symbol of strength and power to other women dealing with fibroids. And it’s just one more step in the crucial fight to take control of women’s menstrual health issues. Especially for Black women like Tanika, who are disproportionately at risk for avoidable hysterectomies. And for the serious complications that often come with open surgery.
As doctors involved in the daily battle against fibroids, we salute Tanika, our forever #WCW. We invite all women who are dealing with fibroids to slip on their white dresses and take control of their health by learning more about UFE, a minimally invasive treatment for fibroids!
Have you ever wondered about problems with pregnancy and fibroids? When you learn that you have fibroids, it means that you have a non-cancerous tumor in your uterus. And, since your uterus is a large, layered organ, we classify and name fibroids based on where in your uterus they develop.
In case you need a review: your uterus has three layers: the outer serosa; the middle, muscular myometrium; and the inner lining—the endometrium. This endometrium is the lining that you shed each month during your period.
Now that you’ve got the anatomy down, we’ll get to classifying fibroids. There are three different types of fibroids. 1. Uterine fibroids that develop beneath the outside covering of the womb are called sub-serosal.
2. If they form in your uterine muscle, they are intramural.
3. And if fibroids pop up in your uterine cavity, inside the endometrium, they are submucosal.
When it comes to pregnancy and fibroids, tumors that develop in your womb can have the greatest impact on your pregnancy. If the fibroid is large enough to change the shape of your womb, you may experience pregnancy complications. Common side effects include, spotting and pain. Your fetal growth could be limited, because fibroids take up too much space in your uterus. With pregnancy and fibroids, your risk for premature delivery and miscarriage also increases. And during your pregnancy, you’re also at risk for placental abruption (when your placenta detaches from your uterus.)
In some cases, your fibroid may require you to have a C-section. That’s because its growth can alter your baby’s position, or block off your delivery pathway.
Getting Pregnant with Fibroids
Sometimes, the location of your fibroid can make it difficult to become pregnant. In fact, we find fibroids in between 5% – 10% of women with infertility. The most common culprits? Fibroids that are inside your uterine cavity (submucosal). You may also have trouble getting pregnant with very large intramural fibroids (the ones within the wall of your uterus.)
Luckily, most women with fibroids can still become pregnant. But if you have fibroids and plan to get pregnant, you should receive a thorough medical evaluation. After all, fibroids can impact your fertility in several ways.
They can changes your cervix shape, limiting the number of sperm that enter your uterus. Depending on location, fibroids can also change your uterine shape, getting in the way of sperm or fertilized embryos. Some fibroids may block your fallopian tubes, which keeps your egg from traveling to your uterus for fertilization. Also, fibroids can impact your endometrial lining, making it harder for embryos to implant. This problem is further complicated if fibroid affect blood flow to your uterine cavity. Why? Limited blood makes it even tougher for embryos to implant in your uterus.
Fibroids and Pregnancy: Concerns After Conception
Now you know what you need to watch out for when you’re trying to conceive. But here are some concerns to understand when you’re dealing with pregnancy and fibroids.
Submucosal fibroids can restrict your fetus’ growth, because they take up space in your uterus. Towards the end of your pregnancy, you may also experience more pain as your growing baby and your fibroid fight for limited space.
Any fibroid that changes the shape of your cervix increases your risk for a breech delivery. (That’s when your baby is born feet-first, instead of the more optimal head down position.)
If your fibroid blocks your baby’s placenta, the placenta could break away from the inner wall of your uterus before your delivery, impacting your baby’s nutrition and oxygen levels. (Called placental abruption, this situation can leave you with heavy bleeding. And it may mean a forced early delivery for your baby.)
Now, we know these are all scary ideas. But here’s some good news for you. First of all, these complications occur in between 10 to 30% of pregnant women with fibroids. So, your pregnancy could be unaffected. And, most fibroids don’t grow during pregnancy. In fact, with your changing hormone levels, some fibroids may even shrink while you’re pregnant.
Still, given the potential risks to you and your growing baby, you should talk to your healthcare provider about your fibroids if you want to become or already are pregnant. Or, if you’re thinking of starting your family, and you’ve been diagnosed with fibroids, schedule a consultation with our Houston fibroid specialists. We can review treatment options that can help you conceive and safely carry your baby to term.
Do infertility and fibroids go together? That’s a very good question Of course, for women who haven’t completed their families, a fibroid diagnosis can be scary. So one of the first questions we hear from patients is often, “Can I still have a baby with fibroid tumors?”
The answer is, unfortunately, not completely clear cut. Without treatment, some women still won’t be able to get pregnant. But many women will have trouble conceiving without some kind of fibroid treatment. And that’s just the beginning of the story.
Infertility and Fibroids Size
If fibroids stay small, or develop in places where fertility isn’t affected, you may get pregnant without problems. But if your fibroids get large, they may physically block your egg from joining up with male sperm.
Then, even if the sperm and egg can join together, a large fibroid could stop the new embryo from implanting in your uterine lining. And, even if an embryo does implant, an untreated tumor can negatively impact your developing fetus.
So, that’s the bad news…at least part of it. Because fibroids can also affect women’s fertility in other, less obvious, ways.
How Fibroids Change Your Body
While some changes are subtle, others may cause big problems for your health. Some women experience cervix shape changes due to fibroids. If that happens to you, it can limit sperm entering your uterus. And that’s not all. These growths can also change the shape of your uterus. Which could decrease the number of places where an embryo can successfully implant. Finally, can weaken your uterine cavity lining. They can also decrease the amount of blood reaching a growing fetus. And both of these issues could lead to miscarriage.
Fibroids Don’t Have to End Your Fertility Journey
With all the tolls fibroids can take on your reproductive system, there is still good news: many women who have been diagnosed with fibroids go on to have one or more children. While many women used to automatically undergo hysterectomy (complete removal of the uterus) after learning they had fibroids, these days there are many fertility-preserving options.
Many women who plan on having children will choose to have a myomectomy (surgically remove the uterine fibroid.) Other women will choose to have a less invasive procedure, like Uterine Fibroid Embolization (UFE), that shrinks their fibroids by permanently cutting off the non-cancerous tumor’s blood supply. Although the research is not conclusive, many women who have UFE have been able to move on and complete their families in the way they want.
If you’re choosing UFE vs Myomectomy, talk to your doctor and our specialists. That way, you can fully understand the impact of your choice. Also, you may benefit from the infographic at right, reposted from the New England Journal of Medicine.
A fibroid diagnosis can certainly be scary, especially if you aren’t done having children, but in this case, knowledge really is power. Getting informed about all your options and choosing the best solution for your family will go a long way towards keeping fibroids from derailing your reproductive plans.
We hear this question all the time: Can I have a baby with fibroids? We understand: if you have fibroids—non-cancerous tumors that grow in your uterus—you may be worried about your fertility. Will you be able to get pregnant? Or, if you get pregnant, will the fibroids affect your baby’s growth and birth? Unfortunately, fibroids can impact your ability to become pregnant or deliver a healthy baby. But that doesn’t mean your dreams of having a family will never come true. Let’s take a closer look.
Will fibroids affect my fertility?
Depending on the size and location of your fibroids, the tumors can block sperm from reaching and fertilizing one of your eggs. Fibroids can also make it more difficult for a fertilized embryo to implant in your uterus. And, if you do become pregnant, fibroids may impact fetal development if they are located in a spot where your baby should be growing. For these reasons, you may want to treat fibroids before becoming pregnant. But your doctor can better advise you regarding fibroids and your fertility options.
Can I Have a Baby with Fibroids?
If you get pregnant while you have fibroids, your fetus could be affected, as we already mentioned. Luckily, a new study suggests a way to carry your baby without impact. In fact, 90% of participants carried their babies to full term!
The study followed 120 women with large fibroids in their first trimester. Then, those fibroids kept growing during the second trimester. And that’s a problem, since about 46% of pregnant women with large fibroids miscarry.
To help these women, researchers divided them into four groups. One group received a cervical procedure and targeted progesterone therapy. Another group received both treatments and a myomectomy. (That’s a surgery to remove individual fibroids.) Then, a third group only received progesterone therapy. And the fourth group of women only received traditional maternal medical care.
At the end of the study, results were promising. The women who had cervical procedures and progesterone treatment reduced their miscarriage rate more than two times over compared to just progesterone treatment. And, compared to no-intervention, miscarriage rates dropped by 11.2%.
Of course, this news is promising for pregnant women with fibroids. But some women may prefer to treat fibroids before getting pregnant. Or, you may need to treat your fibroids in order to successfully conceive. So, if that’s the case for you, keep reading to learn more about the best fibroid treatments for family planning.
What fibroid treatments should I choose to help my fertility?
Thankfully, you have many treatment options when it comes to fibroid tumors. It’s important to talk to a fibroid specialist about your family goals so you can choose the one that’s best for you.
In our Houston fibroid practice, we offer a treatment known as Uterine Fibroid Embolization (UFE). It is a minimally-invasive, non-surgical option that shrinks and kills fibroids by cutting off their blood supply. The procedure is performed through a catheter inserted through your arm. Particles are injected to the catheter to block the artery feeding your fibroids. Many women who undergo UFE go on to have healthy pregnancies.
Some women who still want to get pregnant may prefer a myomectomy—the surgical removal of your fibroid. If that’s the treatment option you select, you’ll need to give your uterus three to six months of healing time before trying to get pregnant.
One final word of warning, to help you manage your expectations: if you’ve had six or more fibroids removed surgically, research shows that you have a lower chance of getting pregnant than women with fewer fibroids. It’s also important to note that myomectomy may weaken your uterus, so it may be safer to deliver your baby via C-section following this fibroid treatment option.
Fertility and fibroids are a tough combo. Today, Bravo TV star Kandi Buress has three children. But just a few years ago, she came forward, talking about how fibroids affected her fertility. In 2015, the then 38-year-old had been trying for two years, unsuccessfully, to have a second child. When she and husband Todd Tucker finally decided to turn to IVF for help conceiving, the couple discovered what was at the heart of their fertility problem: Kandi had a uterine fibroid.
Facing the Problem of Fertility and Fibroids
At the time, Kandi was surprised. (Even though up to 80% of black women will develop fibroids in their lifetime.) She told reporters, “We realized I had a fibroid—a big one—inside the cavity of the uterus where your baby would implant.” Immediately, she worried about ever having another child.
Like Kandi, many women with uterine fibroids experience difficulties becoming pregnant. In fact, research shows that fibroids are involved in 10% of female infertility cases. And, for up to 3% of women, fibroids are the only known cause of that infertility.
In Kandi’s case, her story had a happy ending. She has since has two more children. And she chose to share her story with fans, in order to give other women hope. Which is why, today, she’s our #WCW.
She said, “Luckily for us, it was a blessing, and we actually had success with the first IVF treatment. It takes a couple of months for you to go through the whole process of injections, retrieving the eggs and all of that stuff, then allowing them to put them back in and praying that they take. One of our eggs took.”
Fibroid Recovery and Conception
Of course, some women cannot conceive easily with fibroids. For that reason, they must treat the tumors before getting pregnant. Now, many fibroid suffers think surgery is the only way to treat fibroids and preserve fertility. But that’s not actually true! In our Houston Fibroid office, we offer a non-surgical, minimally invasive treatment known as Uterine Fibroid Embolization. After UFE, your fibroids shrink permanently. And pregnancy is still possible for many women!
In fact, many reports and studies show women getting pregnant after UFE. These studies also show that fertility rates and miscarriage rates in UFE patients are no different than patients of the same age who don’t treat their fibroids. Still, if you want to get pregnant, you may prefer a myomectomy. (This is a surgical fibroid removal). That’s because, if you are healthy enough to get through surgery, some studies suggest you’ll have slightly less pregnancy complications than you would after UFE.
The important thing to remember in all this is that a fibroid diagnosis does not mean the end of your dream to carry a child. Like Kandi Buress and many other women, your path to fertility can be successful. It’s simply a question of knowing your options and making the informed decision that’s best for your body and your family. So make an appointment with our specialists today. We can review your options and help you complete your family!
Infertility is a major concern if you have non-cancerous uterine tumors. After all, your fertility is an important health marker, even if you don’t want a child right now. But fibroids aren’t the only cause of infertility. So, regardless of your family plan, it’s important to understand what’s causing your infertility. And, to help you investigate, here are some of the top culprits to explore if you’re dealing with infertility:
1. Infertility and Fallopian Tube Issues
When functioning properly, your fallopian tubes act as a highway for your eggs. During ovulation, eggs travel down the tubes; if an egg meets sperm at the end of its journey, it can become a fertilized embryo. If, however, your fallopian tubes become blocked or damaged, sperm can’t meet your eggs. And even if the sperm and egg do connect, the fertilized embryo will have a harder time travelling to your uterus for implantation. While many things can cause damage to your fallopian tubes, PID (pelvic inflammatory disease) and STIs or STDs are often responsible.
2. Endometriosis Impacts Fertility
Endometriosis is a painful condition in which endometrium, the tissue that’s normally found in the lining of your uterus grows outside the uterus. Often, this misplaced tissue develops in your ovaries or fallopian tubes. Endometriosis can be painful. It affects your menstrual cycle and, often, your ability to conceive.
PCOS, or Polycystic ovarian syndrome, is a hormonal disorder that causes your ovaries to become enlarged and covered in cysts at their edges. Another characteristic of this condition is that women produce more male hormones than is typical. Approximately 10% of women are affected by PCOS. Symptoms include irregular menstrual cycles, obesity, excess hair growth, higher risks of diabetes and acne.
4. Uterine Fibroids and Infertility
Uterine fibroids are non-cancerous tumors that develop in or on your uterus. Fibroids can develop inside your uterus, on its lining, inside its wall or even on the outer surface of your uterus. Fibroids can affect your menstrual cycle, your ability to conceive and your ability to carry a successful pregnancy to term.
Secondary infertility is often tied to fibroids. (This means you’ve had one baby, but are struggling to become pregnant again) Why? If you develop new fibroids after your first pregnancy, you may not conceive. The same could be true if an old fibroid got bigger after your first baby. If that’s your situation, discuss a fibroid exam with your doctor. We are also happy to offer remote fibroid consultations at this time.
5. Thyroid conditions
Thyroid hormones regulate, among other things, fertility and pregnancy in as much as they are a major part of human growth and development. Hypothyroidism, a condition in which your thyroid hormone levels are low, can stop your ovaries from releasing eggs for fertilization.
6. Egg problems
Every woman has a different number and quality of eggs that may be produced by her ovaries. Some women have fairly low egg counts. Other women have plenty of eggs, but the ones she has are not up to the task of creating a baby. Egg count and quality decrease with age, so women with advanced maternal age may be inclined to check their egg quality when grappling with infertility.
7. Uterine Polyps and Infertility
Polyps are uterine growths, but they are different than fibroids. (Learn the difference between polyps and fibroids here.) Still, like fibroids, polyps can lead to infertility. That’s because they have a stalk that attaches to the membrane lining your uterus and/or cervix.
Unfortunately, many different causes of infertility manifest with the same symptom—irregular or heavy menstrual cycles. In many cases, you can only pinpoint the cause of your infertility by ruling out all other possibilities. If you are concerned that fibroids may be the cause of your infertility issues, schedule a consultation with Dr. Fox or Dr. Hardee in our Houston area fibroid clinic today.
When choosing fibroid treatments, your two main choices will be surgery or UFE. Fibroid tumors are non-cancerous growths that develop in and on a woman’s uterus. While not a life threatening condition, because of their location, they can cause many negative symptoms, including problems with fertility, menstruation, and your bowel and bladder function.
Some women have a higher risk for developing fibroids. While we don’t know why these tumors form, we do know that certain factors are connected. That means if you have a family history, or are an African American women, you are more likely to develop fibroids in the future.
If your fibroid risk is high, now’s the time to think about your fertility. Women with fibroids who want to have children are often pushed into surgery treatment. Previously, we thought myomectomy, surgical fibroid removal, was a woman’s best option if she wanted to get pregnant. Now, research suggests that isn’t the case.
Quality of Life with Fibroid Treatments
There’s a new FEMME study, published in the New England Journal of Medicine, comparing myomectomy and UFE outcomes. Specifically, the study examines how each fibroid treatment affects your post-procedure quality of life. And the outcomes were very interesting.
After treating fibroids with surgery or UFE, each group of women rated their quality of life. Both groups of women reported significant improvements. And there was only an eight point difference between the two groups’ reported improvements. That difference is small enough to be considered statistically insignificant. Or, to put it simply, myomectomy and UFE provides almost identical improvements in your daily life. But their post-treatment recovery process is different: UFE has almost no down time. While myomectomy is still an invasive surgery, which may require a hospital stay.
Given these differences, the FEMME study should offer proof that you should explore UFE if you’re considering myomectomy. Since the two fibroid treatments offer similar benefits, and UFE comes with an easier recovery. Now, it’s important to remember that the FEMME study didn’t address fertility outcomes with either of these fibroid treatment options. So we’ll turn to that data in the next sections of this post.
Myomectomies Don’t Improve Fertility
Check this out. A study examining “the effect of myomectomy on fertility[discovered] no significant benefit,” according to a review in the Cochrane journal. In other words, even if you have surgery to remove your fibroid tumors, your chances of getting or staying pregnant may not improve.
Of course, this is just one study. We need more research to really prove the effect of fibroid surgery on fertility. It does, however, mean that women should carefully consider all their treatment options before rushing into surgery just to preserve their fertility dreams.
UFE and Pregnancy
Patients with fibroids who hope to get pregnant may also consider uterine fibroid embolization, a minimally invasive procedure that effectively kills fibroids by cutting off their blood supply. Many patients wishing to avoid myomectomy want to know if they can become pregnant after uterine fibroid embolization. There have been reports of many successful pregnancies in patients after UFE. Many studies show that fertility rates and miscarriage rates in UFE patients are no different than patients of the same age with fibroids who have had no treatment. But, if you are willing to have surgery, and you’re healthy enough for a myomectomy, discuss the advantages with your provider.
Early studies suggested a slight increase in pregnancy complications after UFE vs myomectomy. But newer science suggests that tweaks to the UFE process improved fertility and pregnancy outcomes. These pregnancy complications can include pre-term labor and pregnancy induced hypertension, also known as pre eclampsia. UFE can still help patients who aren’t good candidates for surgery. All this will be especially true if it turns out that myomectomy really can’t improve your fertility.
Experiencing fibroid symptoms is far more common than you might think. According to the National Institutes of Health, 80 to 90 percent of African American women and 70 percent of Caucasian women will develop fibroids before the age of 50.
Since uterine fibroids are prevalent, can cause severe symptoms and can even lead to trouble getting or staying pregnant, it is important to know the warning signs of fibroid development.
But it’s also important to recognize that some uterine fibroids and endometriosis both cause similar symptoms. (Endometriosis is a condition in which tissue from your uterus, endometrium, grows in or on other parts of your body.) Like women with fibroids, women with endometriosis may experience heavy, painful periods as well as bleeding between periods.
The best way to diagnose the cause of your symptoms is to see your healthcare provider. But you can also narrow down the cause of your pelvic pain and heavy bleeding by better understanding your risk for developing fibroids.
Who is At Risk for Fibroid Symptoms en?
African American women are three times more likely than caucasian women to develop fibroids; they are also more likely to develop several fibroids at a time. Other factors that could increase a woman’s risk of developing fibroids include your age (being over 40) and your weight, since obesity increases your risk. You should also learn your family history of fibroids, and understand that high blood pressure, or never having a pregnancy, could also increase your risk.
Can I Lower My Fibroid Risk?
While many factors can increase your fibroid risk, there are steps you can take to lower your risk of developing these non-cancerous uterine tumors. Some measures include:
Every case is different and some women may never experience symptoms, but a majority of women with fibroids experience at least one of these three common symptoms.
Excessive Menstrual Bleeding
The most common symptom for women with fibroid tumors is excessive bleeding while menstruating. Often times, the bleeding is prolonged, causing periods to last longer than normal. This can lead to soiling of clothing and may interfere with everyday activities.
Pelvic Pain & Pressure
Women with fibroids may feel pain in their lower abdomen. As fibroids grow larger, depending on their size and location, they may cause pain by putting pressure on organs. In addition, it could cause swelling that is often mistaken as weight gain or pregnancy.
Loss of Bladder Control
Fibroids can press against the bladder causing frequent urination and even loss of bladder control. Not only can this cause a great deal of pain, it can disrupt your everyday activities. In addition, fibroid growth can place pressure on the bowel, causing constipation and bloating.
Reaching a Uterine Fibroid Diagnosis
If you are experiencing any of the symptoms listed above, schedule an appointment with our fibroid specialists. Fibroids can usually be found during a simple abdominal or pelvic exam. If your doctor feels that you may have fibroids, an ultrasound or MRI may be used to confirm the diagnosis and proceed with treatment. And, if your provider rules out fibroids as the cause of your symptoms, he or she may recommend further testing to confirm or rule out an endometriosis diagnosis.