Pregnancy After Fibroid Surgery & Fertility Effect

It’s also easy to imagine how fibroid growths could have a disruptive effect on gestation. However, recent results from a high-quality clinical study found no definitive link between uterine fibroids and miscarriage, suggesting that fibroids do not significantly increase the risk of miscarriage [5].

• Pregnancy-induced hypertension, preeclampsia, or eclampsia; women with fibroids have an 8% higher risk of pregnancy-induced hypertension, preeclampsia, or eclampsia than the general population.
• Placenta previa – a condition in which the placenta partially or wholly blocks the neck of the uterus, thus interfering with normal delivery of a baby; women with fibroids have a 38% higher risk of placenta previa than the general population.
• Preterm birth – when the baby is born before 37 weeks of pregnancy; women with fibroids have a 17% higher risk of preterm birth than the general population.
• Fetal malpresentation – a condition in which the baby is in an unusual position as the birth approaches, usually requiring a cesarean delivery.
• Cesarean section (c-section) – delivery through surgical incisions made in the abdomen and uterus; women with fibroids have a 17% higher risk of c-section than the general population.
• Peripartum hemorrhage – heavy bleeding after giving birth.

Fortunately for most women with fibroids, the increased risk of pregnancy complication is marginal, and even when fibroids are a factor, healthy full-term pregnancy is the most common outcome [7].

If you’re concerned about your fibroids or are experiencing fibroid-related symptoms during your pregnancy, you should coordinate with your physician to ensure that you’re being adequately monitored for fibroid-related pregnancy complications.

We often say that there is no perfect treatment for uterine fibroids. Women with fibroids have options, and each of those options have trade-offs. These trade-offs are especially important to consider when it comes to fertility and pregnancy, where fibroid treatment can have lifelong implications. We review each of the options below.

Hysterectomy is a major surgical procedure most-commonly performed by a gynecologist or a general surgeon in a hospital setting. The goal of the procedure is to partially or completely remove the uterus. By removing the uterus, fibroids within the uterus are also removed. Hysterectomy removes the uterus (the womb) permanently, eliminating any possibility of pregnancy after a hysterectomy. If you plan to become pregnant in the future, or if there’s any chance at all that you would like to bear children, you should not get a hysterectomy.

Myomectomy is another major surgical procedure, but instead of completely removing the uterus, a gynecologist or surgeon selectively cuts out the fibroids while preserving the rest of the uterus. Myomectomy is a uterus-sparing procedure, meaning that it is still possible to get pregnant after a myomectomy. However, myomectomy is not always possible, particularly if your fibroids have developed in certain areas, or if you have too many fibroids to treat surgically.

Uterine artery embolization is a non-surgical, minimally invasive treatment. Rather than cutting into the uterus to remove the fibroids, micro sized beads are injected into the arteries that feed the fibroids. When injected, the beads block blood flow to the fibroids, causing the fibroids to ‘starve’ and shrink. Uterine fibroid embolization is usually performed by a Vascular and Interventional Radiologist (IR) that specializes in vascular anatomy and minimally-invasive, image-guided procedures. Uterine artery embolization is a uterus-sparing procedure, meaning that it is still possible to get pregnant after uterine artery embolization.

If you spend time researching the effects of uterine artery embolization on fertility, you will likely find web pages or articles that state that uterine artery embolization can increase the risk of obstetric complications. Some even go as far as to say that uterine artery embolization should be avoided if you plan to conceive afterwards. This guidance is outdated and should be ignored. The evidence is inconclusive on whether or not uterine artery embolization affects fertility or pregnancy complications. More importantly, there are several reports of healthy full-term pregnancies following this therapy [8], including one study that saw a 100% successful pregnancy rate [9].