Getting Pregnant with Uterine Fibroids: Could Fibroids Cause Infertility, What Sizes and Types Matter, and How to Maximize Your Chances

Could fibroids cause infertility? Yes, but most women with fibroids can still conceive naturally. According to the American Society for Reproductive Medicine (ASRM), 2024, fibroids are present in approximately 5–10% of women with infertility and are considered the sole cause of infertility in only 2–3% of cases. Submucosal fibroids, which grow inside the uterine cavity, have the greatest impact on fertility. Intramural fibroids that distort the uterine cavity or are larger than 5–6 cm may also reduce fertility, whereas subserosal fibroids generally have little effect on conception.

Key Takeaways

• Most women with fibroids conceive naturally; fibroids are the sole cause of infertility in only 2–3% of cases.
• Submucosal fibroids lower fertility rates the most by disrupting the uterine lining and embryo implantation.
• Larger fibroids, particularly those that distort the uterine cavity, may increase the risk of implantation problems and certain pregnancy complications.
• Fibroids do not prevent your body from ovulating each month.
• Myomectomy can restore the uterine cavity and improve pregnancy success rates for many women.

How Common Are Uterine Fibroids?

Understanding fibroids and pregnancy starts with recognizing how common these benign tumors are. According to NCBI, fibroids affect an estimated 70–80% of women by age 50. While learning you have a fibroid in the womb can feel overwhelming, most women with uterine fibroids successfully conceive and deliver healthy babies.

What Are Fibroids? Causes, Symptoms, and How to Know

Uterine fibroids, also known as leiomyomas or myomas, are benign (non-cancerous) growths that develop from the smooth muscle of the uterus. They vary in size, number, and location, and many women have no symptoms at all. Fibroids can develop within the uterine wall, beneath the inner lining of the uterus, or on the outer surface of the uterus. Their location can influence the symptoms they cause and, in some cases, their effect on fertility. Fibroids that grow into or distort the uterine cavity are more likely to interfere with implantation or conception than fibroids that do not affect the cavity.

When symptoms do occur, they may include heavy menstrual bleeding, pelvic pressure, frequent urination, constipation, or difficulty becoming pregnant, depending on where the fibroids are located. Understanding what causes fibroids, recognizing their symptoms, and knowing when to seek medical evaluation can help you make informed decisions about your reproductive health and fertility.

What Causes Fibroids in the Uterus?

The exact cause of fibroid growth in the uterus involves genetics and hormones. Estrogen and progesterone promote fibroid development during reproductive years.

Fibroid in the Womb Symptoms: What to Look Out For

Common symptoms include heavy menstrual bleeding, prolonged periods, pelvic pressure, and frequent urination. Some women experience no symptoms at all.

How to Check for Fibroids at Home: Signs and Self-Awareness

You cannot diagnose fibroids at home. However, you can monitor signs like lower abdominal fullness, heavy bleeding, or pelvic discomfort to discuss with your doctor.

Are Fibroids Hereditary?

Yes, fibroids have a genetic link. You are more likely to develop them if your mother or sister had uterine fibroids.

Can Fibroids Make You Gain Weight?

Yes, large fibroids can cause weight gain or lower abdominal swelling resembling an early pregnancy bump.

Fibroids and Ovaries: How Do Fibroids Affect the Ovaries?

Fibroids grow in the uterus, not the ovaries. Ovarian fibromas (benign tumors of the ovary) are a separate condition and are much rarer than uterine fibroids.

Endometriosis and Fibroids: Can You Have Both?

Yes, you can have both endometriosis and fibroids. Endometriosis occurs when uterine-like tissue grows outside the uterus, and having both conditions can increase pelvic pain.

Types of Fibroids: Intramural, Submucosal, and Subserosal

Where a fibroid grows matters even more than how big it is. This table compares the main types of uterine fibroids at a glance.

Prevalence figures are general estimates; they vary between studies because many women have multiple fibroids and classification methods differ.

Intramural Fibroid: The Most Common Fibroid Type

An intramural fibroid grows within the muscular uterine wall. Small intramural fibroids rarely impact fertility, but larger ones can change how the uterus contracts or the shape of its cavity.

Submucosal Fibroids: Highest Impact on Fertility

Submucosal fibroids bulge directly into the uterine cavity. They disrupt the endometrial lining, making it difficult for a fertilized egg to attach properly.

Ovarian Fibromas: Are They the Same as Uterine Fibroids?

No, ovarian fibromas arise within ovarian tissue. Uterine fibroids develop within the smooth muscle layer of the womb.

Could Fibroids Cause Infertility?

Fibroids cause infertility primarily when their size or location physically blocks sperm, obstructs the fallopian tubes, or distorts the uterine cavity to prevent embryo implantation. If this is the part you have been dreading, take a breath. For most women, a fibroid makes conception something to plan around, not something that is off the table.

While fibroids do make it harder to conceive for some, they are rarely absolute barriers to pregnancy. Submucosal fibroids pose the highest risk of implantation failure, whereas subserosal fibroids on the outer wall rarely cause fertility issues. In assisted reproduction, submucosal fibroids are typically removed before IVF to optimize success rates.

Can Fibroids Affect Ovulation and Cycle Tracking?

Although fibroids can cause heavy menstrual bleeding, spotting, or irregular cycles, they usually do not prevent ovulation. Most fibroids affect the uterus rather than the ovaries, so hormone production and egg release typically continue as normal. However, changes in bleeding patterns can make it harder to identify cycle day 1 or estimate ovulation using a calendar alone, making ovulation tracking tools especially useful.

Can You Still Ovulate with Fibroids?

Yes, you can still ovulate with fibroids. Fibroids change the shape and environment of the uterus, but ovulation is run by hormones from your brain and ovaries.

How Tracking Your LH Surge Helps Women with Fibroids Identify Their Fertile Window

Tracking your luteinizing hormone (LH) surge helps you identify your fertile days. Because fibroids do not alter ovarian hormone output, LH monitoring remains a reliable method to identify your fertile window when trying to conceive.

What Size Fibroids Affect Pregnancy and Fertility?

Size works alongside location. Here is a general guide to how fibroid size tends to affect fertility and pregnancy; individual cases vary, so treat it as a starting point for a conversation with your doctor. Management depends on fibroid location, size, number, symptoms, whether the uterine cavity is distorted, and the individual’s fertility and pregnancy plans. Fibroids that distort the uterine cavity generally warrant closer evaluation when pregnancy is desired.

Fibroids under 3 cm typically do not impede fertility unless they bulge into the inner uterine lining. As fibroids reach 5 cm, 6 cm, or 7 cm, their potential to distort the uterine cavity and alter local blood flow increases significantly.

During pregnancy, larger fibroids (especially those over 5 cm) require closer monitoring due to an increased risk of localized pain (red degeneration), breech presentation, preterm labor, and C-section delivery.

Pregnant Women with Fibroids: Risks and What to Expect

Most women with uterine fibroids go on to have healthy pregnancies and deliveries. However, the size, number, and location of fibroids can influence pregnancy and childbirth in different ways. While many fibroids remain stable or cause only mild symptoms, some may increase the risk of complications such as pain, miscarriage, preterm birth, abnormal fetal position, or the need for a Cesarean delivery. Regular prenatal care and ultrasound monitoring help your healthcare provider track fibroid growth and support the best possible outcome for both you and your baby.

Can I Still Have a Healthy Pregnancy with Fibroids?

Yes, most pregnant women with fibroids experience uncomplicated pregnancies and deliver healthy babies.

How to Deal with Fibroids During Pregnancy

1. Attend all prenatal visits: Your healthcare provider can determine whether additional ultrasounds are needed based on the size and location of your fibroids and the course of your pregnancy.
2. Manage pain safely: Use physician-approved treatments and warm compresses for localized pain.
3. Stay hydrated and rested: Adequate rest reduces uterine irritability and pelvic discomfort.

Fibroids During Pregnancy: Trimester-by-Trimester Guide

• First trimester: Rising estrogen may cause fibroids to grow larger.
• Second trimester: Fibroid growth usually stabilizes, but some women develop pain if a fibroid outgrows its blood supply (called red degeneration).
• Third trimester: Large fibroids may affect the baby’s position, increasing the chance of a breech presentation or the need for a Cesarean delivery.

Pregnancy with Fibroid in Uterus: Monitoring and Warning Signs

Seek immediate care if you experience severe pelvic pain, heavy vaginal bleeding, or early uterine contractions.

C-Section vs. Vaginal Delivery with Fibroids: What to Expect

Vaginal birth is often possible. However, a C-section may be needed if a fibroid blocks the birth canal or causes breech positioning.

How to Get Pregnant with Fibroids: Tips and Treatment Options

Having fibroids does not mean pregnancy is out of reach. The best approach depends on the size, number, and location of your fibroids, as well as your age and overall fertility. Many women conceive naturally without treatment, while others may benefit from lifestyle changes, careful ovulation tracking, or medical or surgical management before trying to conceive. Working with your healthcare provider can help you choose the most appropriate strategy to improve your chances of a healthy pregnancy.

How to Get Pregnant with Fibroids

Focus on timing by identifying your fertile window, maintain a healthy body weight, and consult a fertility specialist early.

Tips on Getting Pregnant with Fibroids: What Actually Works

Focus on precise intercourse timing, treat any uterine cavity distortions, and eat a balanced, anti-inflammatory diet.

Can You Get Pregnant if You Have Fibroids Removed?

Yes, surgical removal (myomectomy) preserves the uterus and restores a healthy environment for embryo implantation, and can improve the chance of pregnancy for many women.

Successful Pregnancy with Fibroids: What Improves Your Chances?

Removing cavity-distorting growths and receiving early prenatal care can improve pregnancy outcomes.

Fibroids and Fertility: Trying to Conceive Next Steps

Consult a healthcare provider for a pelvic ultrasound to map the size, number, and location of any fibroids.

Track Your Fertile Window with Premom

Tracking your cycle is essential when trying to conceive with fibroids. The Premom app pairs with easy@Home LH ovulation test strips to digitize and predict your LH surge. Because fibroids typically do not prevent ovulation, using Premom can help identify your peak fertile days and better time intercourse even when fibroids are present.

Track your fertile window for free with Premom.

Key Terms Explained

• Uterine fibroid: A non-cancerous growth composed of muscle and tissue in or on the uterus.
• Submucosal fibroid: A growth located just beneath the uterine lining that bulges into the uterine cavity.
• Intramural fibroid: A growth embedded within the muscular wall of the uterus.
• Subserosal fibroid: A growth located on the outer wall of the uterus.
• Myomectomy: Surgical removal of uterine fibroids while leaving the uterus intact.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified health provider with any questions regarding a medical condition or fertility plan.

Reference

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3. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Uterine Fibroids. https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
4. American Society for Reproductive Medicine. Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a committee opinion. Fertil Steril. 2024;121(3):412–425. doi:10.1016/j.fertnstert.2023.12.019 https://www.asrm.org/practice-guidance/practice-committee-documents/removal-of-myomas-in-asymptomatic-patients-to-improve-fertility-andor-reduce-miscarriage-rate-a-guideline-2017/
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