In March 2015, my husband and I decided to move forward with IVF. At my exam, I met this really sweet ultrasound tech. She took the time to walk me through the process of the examination and checked in with me to make sure I was comfortable. Thinking back I have had pap smears but I had never had a vaginal ultrasound. So during my exam, the tech told me she saw 2 small fibroids. She said, “Did you know, you have 2 small fibroids about 2 millimeters in size”. She also said, “It’s not alarming but you do have them”. I had never heard that before. In fact, I had never heard about fibroids before my exam. Needless to say, I researched all I could about the subject and now advocate for women to know their status by having an early vaginal ultrasound.
Sidenote: This picture was taken 2 weeks after my exam, which makes me think how much stuff women push to the side in order to live what seems to be a “normal life”.
Here are some facts about fibroids, from our friends at CCRM Fertility
WHAT ARE UTERINE FIBROIDS?
Uterine fibroids, also known as myomas or leiomyomas, are non-cancerous growths in the uterus. They’re very common and as you get older, the higher your chances are of having them. Up to 80 percent of females have uterine fibroids by the time they’re 50.
You might also be at an increased risk for fibroids if you’re overweight, have a family history of fibroids, or are African American.
Fibroids vary in both size and location. There are four main types of fibroids which include.
Intramural fibroids: Located in the muscles of the uterine wall and are the most common.
Subserosal fibroids: Can form on the outside of your uterus.
Submucosal fibroids: Develop just underneath the inner uterine lining and bulge into the uterine cavity.
Pedunculated fibroids: Fibroids that have attached to the wall of the uterus and have developed a stalk-like growth called a peduncle.
WHAT ARE THE SYMPTOMS OF FIBROIDS?
Only about 20-50 percent of people with fibroids have symptoms and oftentimes they’re vague. You might have a heavy or prolonged menstrual period or pain or pressure in your abdomen. There might be pain during intercourse. Depending on where the fibroids are located, you could have frequent urination or constipation.
Most of the time, you might not be aware you have fibroids because you won’t have any symptoms. When they’re discovered, it tends to be during an evaluation when you’re having trouble getting pregnant.
DO FIBROIDS AFFECT FERTILITY?
Having fibroids doesn’t mean you will have infertility. In fact, most people won’t have trouble getting pregnant unless the shape and contour of the uterus are affected. With this, an embryo could have more issues implanting.
Unless they are causing discomfort or affecting your uterus where fertility is impacted, you don’t necessarily have to rush to treat them. While they may need to be removed, you could still move forward with fertility treatments.
TREATMENT OPTIONS FOR FIBROIDS
Fibroids can be diagnosed with a physical exam to check the size and shape of your uterus, along with an ultrasound. If fibroids are small and not causing symptoms, you might not need treatment.
Hormone therapy, such as birth control pills or using an IUD, can help temporarily manage your pain. Gonadotropin-releasing hormone (GnRH) antagonists might help to shrink fibroids. Hormone treatment can be an option for moving forward with fertility treatments without delays.
In general, fibroids should be addressed and removed before they grow larger. Surgery to remove fibroids depends on how big they are and where they’re located. Most of the time, laparoscopic surgery can safely be done, but more invasive surgery may sometimes be needed.
Lifestyle changes can help manage fibroids, including a healthy diet, regular exercise, and adequate sleep. These are the best ways for getting your body ready for pregnancy, in general. It’s important to remember that having fibroids doesn’t mean you’re infertile and isn’t a barrier to getting pregnant.
If you want to find out if fibroids are affecting your fertility, talk with your CCRM Fertility specialist about an evaluation.
Written by: Dr. Brian Levine, a board certified reproductive endocrinology and infertility specialist and practice director at CCRM New York
Black Women and Infertility 