Involuntary childlessness and myomas
Due to the demographic development in Germany, the topic of "uterine myomas" also affects many women seeking fertility treatment, as fertility often only becomes an issue for women after the age of 30.
In 40% of these women alone in the age group of 35 and older, the presence of a myoma is suspected. Both the myomas themselves and their treatment can affect pregnancy.
Can myomas make someone infertile?
In most cases, it is possible to become pregnant with fibroids. However, it may be more difficult to become pregnant with fibroids. One can easily imagine that a large fibroid in the uterus takes away the space for the fertilized egg to implant, to put it simply. This can lead to a reduction in fertility, for example through deformation of the uterus, pressure on the fallopian tubes or the cervix, and through circulatory disorders in the uterine lining. This can make it more difficult for the egg cell and the sperm to meet. Additionally, additional obstacles arise due to heavy bleeding and inflammatory processes, which make it more difficult for the fertilized egg to implant into the uterine lining. The position and size of the fibroid or fibroids are crucial for influencing fertility.
In general, one can assume that
- Submucosal fibroids can impair fertility.
- Intramural myomas may impair the ability to become pregnant and hinder the carrying of a pregnancy.
- Subserous fibroids have no effect on fertility
The size of the fibroids or the number of fibroids affect fertility and can become a problem during pregnancy. The risk of miscarriage can increase.
Myom therapy for fertility problems
If there is a desire to have a child, the uterus (uterus) and the endocrine organs (ovaries) should be as least damaged as possible. Despite all surgical expertise, it may be useful (depending on the age of the woman, the location and size of the fibroid knots) to include a medical treatment for fibroids (see below) in the overall plan for fertility treatment. The medical therapy can help shrink the fibroids and thus make fibroid removal less risky. Despite all preference for non-surgical, conservative therapy, the side effects and risks of the medications must be discussed with the patient.
Pregnancy & childbirth with a myoma
In about 30% of the women, growth of existing fibroids occurs during pregnancy. Myomas generally do not play a role in the course of labor. If the birth canal is obstructed, a cesarean delivery is indicated. Removal of a fibroid during pregnancy will rarely be indicated. Twisted subserous fibroids are the exception here. During a cesarean section, existing fibroids cannot be removed „just like that.“ Unpleasant intraoperative bleeding from the wound bed could be the result.
