Uterine Fibroids (proper medical terminology is myoma or leiomyoma) Fibroids are very common - they are benign (non cancerous) tumors of the uterine muscle. The size and location of the fibroid are important. The large majority of them are very small or located in an area of the uterus such that they will not have any impact on reproductive function.

There are 3 general locations for fibroids:

1. Subserosal - on the outside surface of the uterus
2. Intramural - within the muscular wall of the uterus
3. Submucous - bulging in to the uterine cavity
• The only type that is supposed to have a large impact on reproductive function (unless they are large or numerous) is the submucous type that pushes in to the uterine cavity.
• These are much less common than the other 2 types of fibroids.
• Because of their location inside the uterine cavity, submucous fibroids can cause fertility problems and miscarriages.
• Submucous fibroids can often be surgically resected to improve fertility.

Can fibroids decrease fertility?

Approximately 5% – 10% of infertile women have fibroids. Their size and location determines whether fibroids affect fertility. Examples include fibroids that are inside the uterine cavity (submucosal) or very large (>6 cm in diameter) within the wall of the uterus (intramural). Most women with fibroids will not be infertile. Women with fibroids and their partners should be thoroughly evaluated to find other problems with fertility before fibroids are treated. A fertility specialist can help assess if fibroids might be hampering conception.

How do fibroids cause infertility?

There are several ways uterine fibroids can reduce fertility:

• Changes in the shape of the cervix can affect the number of sperm that can enter the uterus.
• Changes in the shape of the uterus can interfere with the movement of the sperm or embryo.
• Fallopian tubes can be blocked by fibroids.
• They can impact the size of the lining of the uterine cavity.
• Blood flow to the uterine cavity can be affected. This can decrease the ability of an embryo to stick (implant) to the uterine wall or to develop.

What happens to fibroids during pregnancy?

Fibroids are found in 2% to 12% of pregnant women, but not all fibroids get larger or cause problems in a pregnancy. If a fibroid grows, it usually does so in the first 12 weeks of pregnancy.

Uterine fibroids are common and can affect fertility in many ways. They can affect whether sperm and egg meet, they can affect whether an embryo can implant, they can affect whether a pregnancy can continue, and they can affect the growth and positioning of the baby. Treatment is decided on a case-by-case basis. It is based on the symptoms of fibroids and may improve overall fertility.

Treatment for fibroid in infertility surgical resection of fibroid by laparoscopy or open myomectomy depending on the size of fibroid is the treatment of choice. once the fibroid is resected patient can proceed with the treatment of fertility