By: Diana Barnes-Brown for Fibroids1For women and couples with dreams of children, a diagnosis of uterine fibroids can be a crushing piece of news.
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Symptomatic uterine fibroids, benign tumors that grow inside the uterus and in the uterine wall, are at best a nuisance and at worst a painful and dangerous stumbling block to fertility and a healthy sex life, or indeed any kind of normal day-to-day life. According to the National Institute of Child Health and Human Development, a division of the National Institutes of Health, roughly 25 percent of women suffer from symptomatic fibroids, and as many as 77 percent of all women develop some form of fibroids – either symptomatic or non-symptomatic – sometime before menopause. Fibroids are also one of the most common disorders of the female reproductive tract.
The symptoms of fibroids may include abnormal bleeding, abdominal pain, pain during sex, urinary and bowel problems, back pain, anemia and infertility or miscarriage. However, since these symptoms can be due to a variety of other causes, and up to two thirds of women with fibroids don’t know they have them, some women may never receive a diagnosis until fibroids are found through testing in an attempt to solve some other, or yet to be determined, problem.
While some women may be unable to get pregnant due to fibroids, others may get pregnant in spite of the growths. This is because the level of fibroid interference may depend on their location, size and number. While a woman with multiple large fibroids inside the uterine cavity may not be able to conceive, a woman with one or two pea-sized growths in the muscle wall of the uterus might not notice any variation in how her body works. In some cases, the changes in physiology and hormones during pregnancy may actually lead to a fibroid that grows in tandem with the developing embryo or fetus.
While there has been a big focus on efforts to restore fertility to women rendered infertile by their fibroids, and indeed great strides have been made in this department, many women are left with another pressing question about their reproductive health: If pregnancy does occur when fibroids are involved, what are the risks? Is it safe to carry such a pregnancy to term?
The answer, in large part, depends on the specific woman’s health status, including, the status of her fibroids, other related health conditions and her overall medical history.
Generally, fibroids will not cause harm during later pregnancy or delivery, but they can cause miscarriage early on by disrupting conditions in the uterus. Bleeding due to fibroids can also increase the risk of miscarriage, and if fibroids are inside the uterine cavity, rather than in the muscle or outside of the uterus, they may disrupt implantation of the embryo and proper development of the placenta. Also, as the fetus grows, the combined pressure of the growing fetus and fibroids can cause significant pain in some cases.
There is some data suggesting that routine pregnancy tests such as amniocentesis or chorion villus sampling (CVS) may result in ruptured membranes, contractions and miscarriage more frequently for women with fibroids.
The research on exactly how, or how much, pregnancy may be affected by fibroids is inconclusive, however, because different studies test for different symptoms and examine different types of fibroids, meaning that the data from one study may indicate that fibroids and pregnancy simply don’t mix, while the data from another may find only moderate interference from the condition. Either way, it seems clear that there are risks, despite the uncertainty of how severe these risks are.
Even so, there are a number of women with fibroids who have carried a pregnancy to full term with minimal or no complications. Also, as tests to monitor progressing pregnancies become more advanced – recently, for example, medical scientists published research suggesting that cervical swab tests similar to Pap smears may be sufficient to monitor generally healthy pregnancies – the chance of disrupting fibroids, and in turn pregnancies, will decrease.
With conflicting research findings and ever-improving treatments for fibroids, the answer seems to be that while it may be ill advised for women with problematic fibroids and many symptoms to pursue pregnancy until their overall reproductive health is in check, women who get pregnant in spite of fibroids or develop fibroids as a result of pregnancy often have little to worry about. As with any pregnancy, the most important thing women can do to ensure their continuing health is listen to their bodies and consult with physicians about the best course of action as they move closer to motherhood.
