Fibroids and infertility

Abstract

Fibroids are the commonest benign tumors of female genital tract. Though fibroids may not be a sole cause for infertility in majority of cases, but it has been seen that there is an improvement in pregnancy rates after myomectomy. Fibroids that distort the uterine cavity and large intramural fibroids are shown to be associated with adverse effects on reproductive function. Available evidence suggests that submucosal, intramural, and subserosal fibroids interfere with fertility in decreasing order of importance. In infertile women and those with recurrent pregnancy loss, myomectomy should be considered only after a thorough evaluation has been completed. Medical management of fibroids has no role in treatment of fertility rather it might lead to delay in the final treatment for infertility. Preoperative medical treatment with a GnRH agonist should be considered for women who are anemic and those undergoing hysteroscopic myomectomy. Subserosal fibroids have least effect on fertility, so they do not need removal before infertility treatment.