Fibroids and Pregnancy in 2025: Risks, Treatments, and What to Expect

Introduction

Fibroids are noncancerous growths that develop in or on the uterus, commonly affecting women during their reproductive years. While many women with fibroids experience no pregnancy issues, these growths can sometimes complicate conception and pregnancy outcomes.

Statistics show that between 20% and 80% of women develop uterine fibroids by age 50, with approximately 30% of women aged 25 to 44 showing symptoms. This makes understanding fibroids crucial for women planning pregnancy.

How Do Fibroids Impact Pregnancy?

For most women, fibroids do not interfere with pregnancy. However, research from 2010 indicates that 10% to 30% of pregnant women with fibroids may face complications. The most frequent issue is pain, especially during the last two trimesters when fibroids exceed 5 centimeters in size.

Other potential complications include:

• Fetal Growth Restriction: Large fibroids can limit space in the uterus, hindering fetal development.
• Placental Abruption: Fibroids may cause the placenta to detach prematurely, reducing oxygen and nutrient supply to the baby.
• Preterm Labor: Pain from fibroids can trigger uterine contractions leading to early delivery.
• Cesarean Section: Women with fibroids are up to six times more likely to require a C-section.
• Breech Presentation: Abnormal uterine shape caused by fibroids can prevent the baby from positioning head-down.
• Increased Miscarriage Risk: Fibroids may double the likelihood of miscarriage.

How Does Pregnancy Affect Fibroids?

Fibroid behavior during pregnancy varies. About one-third of fibroids may grow during the first trimester, likely due to rising estrogen levels. Conversely, many fibroids shrink after childbirth, with studies showing that nearly 80% reduce in size postpartum.

Fibroids and Fertility: What You Need to Know

Many women with fibroids conceive naturally without treatment. However, submucosal fibroids—those protruding into the uterine cavity—can increase infertility and miscarriage risks.

Since infertility has multiple causes, your healthcare provider will investigate other factors before attributing difficulties to fibroids alone.

Planning Pregnancy with Fibroids

Discuss with your doctor the size and location of your fibroids to understand their potential impact on conception and pregnancy. Your physician can also advise on treatments that may enhance fertility.

Managing Fibroids During Pregnancy

Treatment options during pregnancy are limited to protect the fetus. Symptom management typically includes bed rest, hydration, and mild pain relief. Rarely, surgical removal (myomectomy) may be considered in the second half of pregnancy if absolutely necessary.

Pre-Pregnancy Fibroid Treatments to Boost Fertility

Before conception, several treatments can help manage fibroids while preserving fertility:

• Myomectomy: Surgical removal of fibroids, often followed by a recommended three-month wait before trying to conceive.
• Hormonal Birth Control Pills: Used to control symptoms; pregnancy is prevented while on the pill.
• Intrauterine Devices (IUDs): Help reduce symptoms and preserve fertility, though pregnancy is not possible while in use.
• GnRH Agonists: Medications that shrink fibroids by suppressing hormone production, with temporary infertility during treatment.
• Myolysis: Minimally invasive procedure using energy to shrink fibroid blood supply.

Each treatment has specific risks and recovery times, so consult your healthcare provider to determine the best approach for your reproductive goals.

Recognizing Fibroid Symptoms

Fibroids often cause no symptoms, but common signs include:

• Heavy or painful menstrual periods
• Spotting between cycles
• Anemia from prolonged bleeding
• Pelvic pressure or fullness
• Pain during intercourse
• Lower back pain and constipation
• Reproductive challenges like infertility or miscarriage
• Frequent urination or difficulty emptying the bladder

Diagnosis is typically confirmed through pelvic exams and ultrasound imaging.

Prognosis and Lifestyle Tips

While fibroids can affect fertility and pregnancy, many women experience healthy pregnancies without complications. Maintaining a balanced diet, healthy weight, and regular exercise may reduce risks associated with fibroids and pregnancy.

If you have fibroids and plan to conceive, work closely with your healthcare provider in 2024 to tailor a safe and effective plan for your reproductive health.

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