If you are planning a pregnancy, or already expecting, and have been told you have fibroids, you deserve clear answers about what that means for you and your baby, not a rushed explanation between appointments.
Uterine fibroids are non-cancerous growths in the uterus that affect an estimated 20 to 80 percent of women by age 50. Most fibroids do not interfere with a healthy pregnancy. When they do, the effects range from mild discomfort to complications such as preterm labor or a required cesarean delivery. Treatment before pregnancy, most often a myomectomy, is generally reserved for fibroids that distort the uterine cavity or have already affected fertility.
What Are Uterine Fibroids?
Uterine fibroids, also called leiomyomas, are benign muscular growths that develop in or on the wall of the uterus. They are extremely common among women of reproductive age, and having them does not mean something is wrong with your health. Fibroids vary widely in size, from a seedling too small to detect on an exam to a mass large enough to change the shape of the uterus.
Where a fibroid sits matters more than whether you have one at all. Submucosal fibroids, which grow into the uterine cavity, are the type most likely to affect fertility and pregnancy. Intramural fibroids, within the uterine wall, and subserosal fibroids, on the outer surface, are less likely to interfere with conception or carrying a pregnancy to term.
How Do Fibroids Affect Pregnancy?
The reassuring truth is that the majority of women with fibroids carry a pregnancy without complications. Existing research suggests roughly 10 to 30 percent of pregnant women with fibroids experience some related issue, which means most do not. Still, it is worth understanding what to watch for, and why your gynecologist may want to monitor fibroid growth with periodic ultrasounds during pregnancy.
Rising estrogen levels can cause fibroids to enlarge, particularly during the first half of pregnancy. Growth typically slows in the third trimester, and many fibroids shrink again after delivery.
Possible complications include:
- Pain. Rapid growth can outpace a fibroid’s blood supply, causing a process called degeneration, which can be uncomfortable but is not typically dangerous.
- Fetal positioning issues. A fibroid that changes the shape of the uterine cavity can limit space for the baby, sometimes resulting in a breech position.
- Placental complications. In some cases, a fibroid located near the placenta’s attachment site can increase the risk of placental abruption.
- Preterm labor. Fibroid-related discomfort and uterine irritability are associated with a modestly increased risk of early labor.
- Cesarean delivery. If a fibroid blocks the birth canal or prevents the baby from turning head-down, a cesarean delivery may be recommended.
- Miscarriage. Certain studies have found a somewhat higher rate of early pregnancy loss among women with fibroids, particularly submucosal ones.
None of these risks are guaranteed, and many patients with fibroids never experience them. Regular monitoring lets your care team catch changes early and plan your delivery with confidence rather than guesswork.
Can You Get Pregnant If You Have Uterine Fibroids?
Fibroids are a factor in an estimated 5 to 10 percent of infertility cases, usually because a submucosal fibroid distorts the uterine cavity or blocks the fallopian tubes, interfering with implantation. Many women with fibroids conceive without any difficulty, particularly when fibroids are small or located outside the cavity.
If you have been trying to conceive without success and already know you have fibroids, or if fibroid symptoms such as heavy bleeding or pelvic pressure have prompted you to look into your fertility, an evaluation with imaging can clarify whether your fibroids are a contributing factor.
Uterine Fibroid Treatment Options
The right uterine fibroid treatment depends on your symptoms, the size and location of your fibroids, and whether you plan to have children in the future. At Kim Gyn, every option is discussed to understand the tradeoffs rather than settle for the first suggestion.
Treatment Comparison Table:
| Treatment | Best suited for | Fertility impact |
|---|---|---|
| Watchful waiting with monitoring | Small, asymptomatic fibroids, or fibroids discovered early in pregnancy | None. No intervention needed. |
| Hormone therapy | Symptom management (bleeding, pain) before a longer-term decision | Temporary measure; not used during active pregnancy planning |
| Myomectomy | Fibroids affecting fertility, causing significant symptoms, or distorting the uterine cavity | Preserves the uterus and is the standard choice for patients planning future pregnancy |
| Uterine fibroid embolization (UFE) | Patients who have completed childbearing and want to avoid surgery | Generally not recommended if future pregnancy is planned |
| Hysterectomy | Severe, recurrent fibroids where fertility is not a consideration | Ends the ability to carry a pregnancy |
For patients who want to have children after treatment, myomectomy is the procedure most gynecologic surgeons recommend. It removes fibroids while leaving the uterus intact, and can often be performed using a minimally invasive, robotic-assisted approach that supports a shorter recovery than traditional open surgery. Whether a laparoscopic, robotic, or open technique is appropriate depends on the size and number of fibroids, which is why imaging and a surgical evaluation come before any recommendation.
Timing treatment Around Pregnancy
If you are planning a pregnancy and already know you have fibroids, treatment decisions are usually made before conception, not during it. Surgery during pregnancy is avoided whenever possible. If fibroids are discovered once you are already pregnant, the approach shifts to monitoring and managing symptoms until after delivery.
Why Manhattan Patients Choose Kim Gyn
Fibroid care sits at the intersection of two things Kim Gyn was built around: surgical expertise and genuine care. Dr. Annie Kim’s practice was designed for patients who have spent years being told their symptoms are normal, and for those with demanding schedules who cannot spend an afternoon on hold to book an appointment.
- Concierge-style access. Direct communication with your care team instead of a phone tree.
- Advanced surgical options. Including robotic-assisted myomectomy for patients who want to preserve fertility.
- Plain-language guidance. Clear explanations of your options and their tradeoffs, with no pressure toward a particular procedure.
Ready for Clear Answers About Your Fibroids?
Book a private consultation with Dr. Annie Kim to review your imaging, discuss your family planning goals, and understand every treatment option available to you.
This page is for general educational purposes and does not replace individualized medical advice. Every fibroid case is different. Please consult Dr. Annie Kim about your specific diagnosis and treatment options.
Frequently Asked Questions About Fibroids and Fertility
Can you have a healthy pregnancy with fibroids?
Yes. Most women with uterine fibroids carry a pregnancy to term without complications. Fibroid size, number, and location determine your individual risk level, which is why monitoring by a gynecologist familiar with your history matters more than the diagnosis itself.
Do fibroids need to be removed before getting pregnant?
Not always. Removal is usually recommended when fibroids are large, distort the uterine cavity, or have already contributed to a miscarriage or fertility difficulty. A pre-pregnancy consultation with imaging can determine whether a myomectomy is advisable in your case.
What is the safest fibroid treatment for someone who wants to have children?
Myomectomy is the standard treatment for patients who want to preserve fertility, since it removes fibroids while keeping the uterus intact. Non-surgical options such as uterine fibroid embolization are generally avoided for women planning a future pregnancy.
Can fibroids grow during pregnancy?
Yes. Fibroids often grow during pregnancy in response to rising estrogen levels, most commonly during the first and second trimesters. Growth does not always cause symptoms, but larger fibroids are monitored more closely with ultrasound.
How do fibroids affect fertility?
Fibroids can affect fertility when they distort the uterine cavity, block the fallopian tubes, or interfere with implantation. Many fibroids, particularly small ones located outside the cavity, have no measurable effect on the ability to conceive.