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Uterine Fibroids and Miscarriage

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Updated February 26, 2008

Uterine Fibroids

Fibroids in the uterus can sometimes cause recurrent miscarriages.

Image © A.D.A.M.

What Are Fibroids?:

Fibroids are lumps of tissue that grow in the wall of the uterus. Fibroids are not uncommon; estimates suggest that anywhere between 20 and 50% of women have some type of fibroid. Fibroids usually develop during adulthood and are not present from birth.

Symptoms:

In many women, fibroids cause no problems. Others, however, may experience pelvic pain, unusually heavy menstrual periods, or fertility problems. In some women, fibroids seem to cause recurrent miscarriages.

Why Fibroids Are Related to Miscarriages:

According to a 2000 study, fibroids are the exclusive culprit in infertility or miscarriages for about 5% of women who have these problems. Doctors believe that the reason why fibroids cause problems for some women and not others has to do with the type of fibroid and its location in the uterus.

How Doctors Diagnose Fibroids:

Doctors can frequently diagnose fibroids by doing a pelvic exam. If the doctor wants more information about the fibroids, especially for a woman having miscarriages or fertility issues, the doctor may also order a hysterosalpingogram (HSG)or an exam called a sonohysterogram, which involves injecting saline solution into the uterus and examining it with ultrasound.

Treatment Options:

Multiple treatments exist for fibroids, and women who have no negative symptoms associated with their fibroids may not even need treatment.

The most drastic treatment for fibroids is hysterectomy, or removal of the entire uterus -- a treatment that would obviously not work for anyone with a goal of getting pregnant again.

Medications that can shrink fibroids also exist, as do other surgical procedures that are less drastic than hysterectomy. One procedure called uterine artery embolization halts the blood supply to the fibroid and has shown increasing success, but the safety of pregnancy after the procedure is unknown.

A surgery called myomectomy would usually be the choice for a woman hoping to get pregnant again. In a myomectomy, the doctor surgically removes the fibroid, sometimes via a hysteroscope or a laparoscope.

The downside of myomectomy as a fibroid treatment is a significant chance of the fibroid recurring; 10 to 25% of women who choose myomectomy as a fibroid treatment will need a repeat myomectomy because of new fibroids. In addition, women who have had a myomectomy may have increased risk of uterine rupture during pregnancy and will need to be followed carefully during prenatal care.

Sources:

Bajekal, N., and T.C. Li, "Fibroids, infertility, and pregnancy wastage." Human Reproduction Update 2000. Accessed 24 Feb 2008.

Hart, Roger, Yacoub Khalaf, Cheng-Toh Yeong, Paul Seed, Alison Taylor, and Peter Braude, "A prospective controlled study of the effect of intramural uterine fibroids on the outcome of assisted conception." Human Reproduction Nov 2001. Accessed 24 Feb 2008.

Stewart, Elizabeth A., "Patient information: Fibroids." UpToDate Patient Information. Sept. 2007. Accessed 24 Feb 2008.

  1. About.com
  2. Health
  3. Miscarriage / Pregnancy Loss
  4. Causes
  5. Two or More Miscarriages
  6. Problems with the Uterus
  7. Uterine Fibroids and Miscarriage - Fibroids As a Cause of Recurrent Pregnancy Loss

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