What is uterine myomatosis and how does it affect fertility?

by Ingenes Institute 09/11/22

Uterine myomatosis is the appearance of myomas or fibroids inside the uterus. These are benign tumors classified by their location. 

The myomas or fibroids inside a woman's uterus are classified in the following way, according to their location:  

  • Intramural: located in the uterus muscle wall and can affect fertility if they reach more than 4 centimeters. 
  • Submucosal: formed in the surface of the uterine lining and can affect embryo implantation.
  • Subserosal: located in the outer cover of the uterus and usually doesn't affect fertility.
uterine-myomatosis-infografic–types-of-fibroids-location

Is it a common condition?

It is the most common pelvic tumor. Approximately 20% of women suffer of uterine myomatosis during their reproductive age (from their first menstruation until menopause) and particularly women ovdf the age of 30. 

Uterine myomas can be microscopic or slowly grow until filling the entire uterus. They have different shapes and sizes, and although they could be just one, most of the time are multiple. 

How does uterine myomatosis affect fertility?

These tumors are present in both fertile and infertile women. Nevertheless, 80% of the cases of infertility because of the uterine factor, is because of the appearance of uterine fibroids that affect the uterine cavity, like the case of intramural and submucosal. 

The location of the uterine fibroids is very important because this determines whether they can potentially cause infertility, change sperm flow, or negatively affect the embryo implantation process. 

Could this condition affect pregnancy? 

Uterine myomas can cause compilations in the pregnancy process, such as:  

  • High risk of miscarriage 
  • Fetal growth retardation
  • Premature delivery because of less space in the uterus
  • Obstruction of the cervical canal 
  • Obstruction of labor 
  • Postpartum hemorrhage
mother-more-than-35-with-newborn-baby-ivf
You may be interested in reading the case of Denisse, who became a mother after 8 years of trying

What are the symptoms? 

Around 25% of uterine myomas are asymptomatic. But they can also manifest through: 

  • Feeling of pressure in lower abs 
  • Abnormally abundant menstrual bleeding 
  • Longer than usual menstrual cycles
  • Painful pelvic cramps
  • Bleeding not related to menstruation 
  • Pain or difficulty while peeing 
  • Infertility
  • Recurrent miscarriages

It is important to point out that uterine myomatosis symptoms depend on the size, location and number of present fibroids

What are the causes? 

Although science hasn't found the specific cause of the uterine myomas, it is known that appearance is related with genetic predisposition

Also, the growth is associated with hormonal changes in the ovaries, in particular with progesterone and estrogen production. 

Uterine fibroids appear during the reproductive stage of women, growing during pregnancy (when there is a high level of hormones), and disappear after menopause when the hormone levels are lower. 

How can I get a diagnosis? 

Reaching a specialist is the first step. The next one, probably, would be a vaginal ultrasound. Which is the most reliable study for uterine myomatosis diagnosis. 

It offers nearly 95% of accuracy when done abdominally and 100% when done intravaginally. 

The vaginal ultrasound must be interpreted by an expert.

Can I become a mother despite being diagnosed with Uterine Myomatosis? 

When it comes to achieving a healthy pregnancy,  treatment of uterine myomatosis depends on the age of the woman, and, above all, the size and location of the fibroids. 

Subserosal myomas rarely affect fertility, but patients with submucosal or intramural fibroids larger than 2 inches, are recommended to consider treatments such as In Vitro Fertilization (IVF), especially if they are over the age of 35. 

In Vitro Fertilization (IVF) is highly effective when uterine myomatosis does not affect the endometrial cavity. 

Fibroids usually change sperm traffic and the embryo implantation process, but In Vitro Fertilization makes it possible for egg fertilization to take place in the laboratory. 

Later, the embryo with the highest implantation potential is transferred into the uterus.

mother-receiving-her-newborn-ivf-baby
You might be interested in the case of Karina, who despite suffering from polycystic ovary syndrome, became a mother

How do I prepare for the process? 

Very rarely do women have to go through a myomectomy before proceeding with the In Vitro Fertilization (IVF) treatment. 

This is a surgery to take out the uterine fibroids, after which the pregnancy probability increases and there is an important decrease in the risk of miscarriage. 

The new IVF cycle must be performed immediately after the uterine myomectomy because the probability of pregnancy decreases after the first year due to uterine fibroids' recurrence. 

If you would like to learn more about uterine myomatosis, visit our guide: What is Uterine Myomatosis?

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