Dr Paul MacKoul on How Fibroids Can Affect Fertility

Jun 19, 2023 5:00 PM ET

Fibroids, also called myomas, are benign muscle tissue tumors in the uterus. They can change the shape of the uterus. About 20 percent of women of reproductive age have fibroids, says Paul MacKoul MD. Dr Paul MacKoul is a gynecologist and co-founder of the Center for Innovative GYN Care.

Fibroids and Infertility

While some fibroids cause no symptoms, others can cause painful menstrual cycles, a sensation of pelvic fullness, and infertility. About 5 percent to 10 percent of infertile women have fibroids, and fibroids are the sole cause of infertility in 2 percent to 3 percent of women, says Dr. MacKoul. 

The fibroid’s size and location determine whether the fibroid will affect fertility. Most women with fibroids will not experience a decrease in fertility. However, fibroids inside the uterine wall, called submucosal, or very large fibroids within the uterine wall, called intramural, are more likely to decrease fertility, Dr. MacKoul says.

Fibroids can negatively affect fertility in several ways, Dr. MacKoul says. One way is by changing the shape of the cervix so that fewer sperm can enter the uterus. Another way is by changing the shape of the uterus, which can interfere with sperm movement. Fibroids also can block Fallopian tubes or affect blood flow to the uterine cavity, decreasing the ability of an embryo to implant or develop. They also can impact the size of the uterine cavity lining. Once a woman becomes pregnant, fibroids can sometimes outgrow their blood flow, causing pain. They can also change the baby’s position in the uterus.

Research also has linked fibroids with increased risks for placental abruption, in which the placenta breaks from the uterine wall. Women with fibroids are also more likely to have a Cesarean delivery, Dr. MacKoul says.

How to Treat Fibroids

Fibroids are treatable, and many forms of treatment preserve a woman’s fertility, says Dr. MacKoul. Properly treating fibroids depends on their location, size, and symptoms. Some fibroids need no treatment at all. In some cases, medicine can shrink the fibroids. Noninvasive or minimally invasive treatment options, such as laparoscopic myomectomy, can also destroy fibroids. In some cases, women require traditional surgery. A gynecologist can present the woman with options and a recommendation based on her specific situation, says Dr. MacKoul. 

About Paul MacKoul MD

Dr. MacKoul received his medical degree from Tufts University. He completed his ob-gyn residency at the University of Maryland and his fellowship in Gynecologic Oncology at the University of North Carolina. He has previously been the director and an associate professor of OB/GYN at The George Washington University Hospital and Washington Hospital Center. His writings have appeared in numerous publications, and he has been named a Top Doctor multiple times by Washington, D.C. area media. 

Content Marketing, No PR, Go Media, Wire, English