Uterine fibroids are incredibly common.
In fact, many women develop fibroids at some point during their reproductive years. Some never know they have them. Others experience heavy periods, pelvic pressure, pain, or fertility challenges.
Fibroids are noncancerous growths that develop in or around the uterus.
Most fibroids are not dangerous. Many do not affect fertility at all.
But some fibroids can interfere with conception or pregnancy, especially depending on their size, location, and number.
This is especially true for fibroids that distort the uterine cavity or affect the lining where an embryo needs to implant.
If you are trying to conceive and something feels off, fibroids may be worth asking about.
In this article, we will walk through 10 signs that fibroids could be affecting your fertility, including a few that are easy to overlook.
Key Takeaways
Fibroids are common, but not all fibroids affect fertility.
Location matters. Submucosal fibroids and some large intramural fibroids may have the biggest impact on conception and implantation.
Symptoms like heavy bleeding, pelvic pressure, painful sex, frequent urination, and recurrent miscarriage may be clues.
Fibroids can sometimes contribute to anemia, implantation problems, or pregnancy complications.
Pelvic ultrasound, saline sonogram, hysteroscopy, or MRI may help your provider evaluate fibroids more clearly.
Treatment depends on your symptoms, fertility goals, age, fibroid type, and overall reproductive health.
Disclaimer
This article is for educational purposes only and is not intended to provide medical advice. Always consult a qualified healthcare provider, OB-GYN, reproductive endocrinologist, or fertility specialist for diagnosis, testing, treatment options, and personalized guidance.
Quick Overview: What Are Fibroids?
Uterine fibroids are growths made of muscle and connective tissue.
They are also called leiomyomas or myomas.
Fibroids can grow in different areas of the uterus, and their location can influence whether they affect fertility.
Common Types of Fibroids
Submucosal fibroids: Grow into or near the uterine cavity. These are often the most concerning for fertility because they can affect the lining and implantation.
Intramural fibroids: Grow within the muscular wall of the uterus. Larger intramural fibroids may sometimes affect fertility, especially if they distort the cavity.
Subserosal fibroids: Grow on the outer surface of the uterus. These are less likely to affect fertility unless they are very large or causing symptoms.
Pedunculated fibroids: Attached to the uterus by a stalk. Their impact depends on size and location.
Fibroids can be tiny or large. Some people have one fibroid, while others have multiple.
Resource: Mayo Clinic: Uterine Fibroids
1. Heavy or Unpredictable Periods
Heavy bleeding is one of the most common signs of fibroids.
But it can also be a clue that the uterus is under extra stress.
Signs to Watch For
You may notice:
Soaking through a pad or tampon every hour
Periods lasting more than 7 days
Passing large blood clots
Needing double protection at night
Bleeding between periods
Feeling exhausted during or after your period
Why It May Affect Fertility
Heavy bleeding can sometimes be linked to fibroids that affect the uterine lining or cavity.
Chronic heavy bleeding may also contribute to iron deficiency or anemia, which can affect energy, hormone health, and pregnancy readiness.
What to Ask Your Provider
Could fibroids be causing my heavy bleeding?
Do I need a pelvic ultrasound?
Should I check ferritin or iron levels?
Is the fibroid affecting the uterine cavity?
Could this impact implantation?
Resource: ACOG: Uterine Fibroids
2. Repeated Failed Implantations or IVF Transfers
If you have experienced repeated failed embryo transfers, fibroids may be one factor worth evaluating.
This is especially important if the fibroid is submucosal or near the uterine lining.
How Fibroids May Interfere
Fibroids may:
Distort the uterine cavity
Disrupt the endometrial lining
Make implantation harder
Affect blood flow to the uterine lining
Create inflammation inside the uterus
Reduce available space for embryo attachment
Why It Matters
Implantation requires a healthy embryo and a receptive uterine lining.
If a fibroid changes the shape or function of the uterine cavity, it may reduce the chance that an embryo implants successfully.
What to Ask Your Provider
Could a fibroid be affecting implantation?
Does the fibroid touch or distort the uterine cavity?
Should I have a saline sonogram or hysteroscopy?
Would removing the fibroid improve my chances?
Should this be addressed before another transfer?
3. Recurrent Miscarriages
More than one miscarriage may prompt your provider to look more closely at the uterus.
Fibroids are not the only possible cause of pregnancy loss, but they may be part of the evaluation.
Why Fibroids May Matter
Fibroids may contribute to pregnancy loss if they:
Distort the uterine cavity
Interfere with placental attachment
Affect blood flow
Trigger uterine irritability
Limit space for early pregnancy development
Submucosal fibroids and fibroids that alter the uterine cavity are often more concerning than fibroids on the outer surface of the uterus.
Important Note
Not all fibroids cause miscarriage.
Many people with fibroids carry healthy pregnancies.
The key question is whether the fibroid’s location, size, or position may be affecting the pregnancy environment.
What to Ask Your Provider
Could my fibroid be related to pregnancy loss?
Is the fibroid inside or near the uterine cavity?
Should I have a recurrent loss evaluation?
Would imaging help clarify the issue?
Would treatment improve future pregnancy chances?
4. Frequent Urination or Bladder Pressure
Needing to urinate often can have many causes.
But if you feel bladder pressure without a urinary tract infection, a fibroid may be pressing on the bladder.
Signs to Watch For
You may notice:
Needing to pee frequently
Waking at night to urinate
Feeling urgency
Trouble fully emptying your bladder
Pelvic heaviness or pressure
Feeling like something is pressing from inside
Why It May Affect Fertility
Bladder pressure itself does not cause infertility.
But it may suggest that a fibroid is large enough to change the shape, size, or position of the uterus.
If a fibroid is large or distorting the uterus, your provider may want to evaluate whether it could affect implantation, pregnancy, or fertility treatment.
What to Ask Your Provider
Could a fibroid be pressing on my bladder?
How large is the fibroid?
Is my uterus enlarged or distorted?
Could this affect fertility or pregnancy?
Do I need treatment before trying to conceive?
Resource: Cleveland Clinic: Uterine Fibroids
5. Pelvic Pain or Pressure That Worsens During Ovulation
Some people with fibroids experience pelvic pain, pressure, or fullness.
This may feel worse during certain parts of the cycle, including ovulation or menstruation.
What It May Feel Like
Fibroid-related discomfort may feel like:
Deep pelvic pressure
Dull aching pain
Heaviness in the lower abdomen
Pain on one side
Bloating or fullness
Pain during periods
Pain during ovulation
Pain during intercourse
Why It May Affect Fertility
Pain can make it harder to track ovulation, time intercourse, or stay consistent during fertile windows.
It may also suggest that there are other conditions present, such as endometriosis or adhesions, which can affect fertility too.
What to Ask Your Provider
Could fibroids be causing my pelvic pain?
Could endometriosis also be involved?
Does the fibroid’s location explain my symptoms?
Should I have ultrasound, MRI, or further evaluation?
Could this affect my fertility plan?
6. Low Iron Levels, Even If You Feel Fine
Fibroids can cause heavy menstrual bleeding, which may lead to iron deficiency.
Sometimes this happens slowly, and symptoms are easy to dismiss.
Signs of Low Iron or Anemia
You may notice:
Fatigue
Brain fog
Dizziness
Cold hands and feet
Shortness of breath with activity
Pale skin or pale inner eyelids
Weakness
Headaches
Rapid heartbeat
Why It May Affect Fertility
Iron is important for oxygen transport, energy, ovulation, hormone function, and pregnancy health.
If fibroid-related bleeding is lowering your iron stores, it may be worth correcting before or during fertility treatment.
What to Ask Your Provider
Should I test ferritin, not just hemoglobin?
Could heavy bleeding be causing low iron?
Should I take iron supplements?
How can we manage the bleeding?
Should fibroids be treated before pregnancy?
Resource: NIH: Iron Deficiency and Fertility
7. Painful or Disruptive Sex Life
Pain during sex can have many causes, and fibroids may be one of them.
Fibroids near the cervix, lower uterus, or uterine lining may contribute to discomfort.
How This May Show Up
You may experience:
Deep pelvic pain during sex
Pain in certain positions
Cramping after intercourse
Avoiding sex during fertile windows
Anxiety around intimacy
Relationship stress around timing
Why It May Affect Fertility
If pain makes intercourse difficult or stressful, it can affect timing during the fertile window.
Painful sex may also point to other conditions, such as endometriosis, pelvic floor dysfunction, or inflammation, so it is worth bringing up.
What to Ask Your Provider
Could fibroids be causing pain during sex?
Could another condition be involved?
Is the fibroid near the cervix or uterine lining?
What options can reduce pain?
How can we time intercourse without increasing stress?
8. Unexplained Fertility Struggles After Age 30
Fibroids often become more common with age.
If you are in your 30s or early 40s and have been trying to conceive without success, fibroids may be worth evaluating, even if your cycles seem regular.
Why This Matters
You may still ovulate regularly and have normal-looking cycles while fibroids quietly affect the uterine environment.
Fibroids may affect fertility if they:
Distort the uterine cavity
Change the lining
Interfere with implantation
Affect blood flow
Coexist with endometriosis or adenomyosis
Grow larger over time
When to Ask for Evaluation
Consider asking about fibroid screening if:
You are over 30 and trying to conceive
You have heavy periods
You have pelvic pressure
You have recurrent pregnancy loss
You have failed transfers
You have a family history of fibroids
You have never had a pelvic ultrasound
What to Ask Your Provider
Should I have a pelvic ultrasound?
Would a saline sonogram show the uterine cavity better?
Could fibroids explain unexplained infertility?
Should fibroids be addressed before IVF or IUI?
Does my age change the treatment timeline?
Resource: ASRM: When to See a Fertility Specialist
9. Enlarged or Misshapen Uterus
A typical uterus is often described as pear-shaped.
Fibroids can sometimes make the uterus enlarged, bulky, or irregular in shape.
How This May Be Found
Your provider may notice changes during:
Pelvic exam
Pelvic ultrasound
Saline sonogram
Hysteroscopy
MRI
Fertility evaluation
Why It May Affect Fertility
A misshapen or enlarged uterus may matter if the uterine cavity is distorted.
This can affect:
Implantation
Embryo growth
Pregnancy comfort
Miscarriage risk
Pregnancy complications, depending on the fibroid
The exact impact depends on the fibroid’s size and location.
What to Ask Your Provider
Is my uterus enlarged or irregular?
Are the fibroids affecting the cavity?
Do I need more detailed imaging?
Could this affect pregnancy?
Would treatment be recommended before conception?
Resource: Johns Hopkins Medicine: Uterine Anatomy
10. Family History or Higher-Risk Background
Fibroid risk can run in families.
Some groups also have a higher risk of developing fibroids earlier, including Black women.
Risk Factors to Know
You may have a higher risk if:
Your mother had fibroids
Your sisters have fibroids
You developed symptoms at a younger age
You have a history of heavy bleeding
You are Black or African American
You have multiple fibroids or early fibroid growth
Why It May Affect Fertility Planning
If you have a higher risk, earlier screening may help you identify fibroids before they interfere with fertility treatment or pregnancy plans.
This does not mean fibroids will definitely affect your fertility.
It simply means it may be worth checking sooner, especially if you are trying to conceive.
What to Ask Your Provider
Does my family history increase my risk?
Should I have a screening ultrasound?
Could fibroids explain my symptoms?
Should we monitor fibroid growth over time?
Does this affect when I should start trying or seek treatment?
Resource: The Fibroid Foundation
What to Do If You Suspect Fibroids
If you are trying to conceive and suspect fibroids may be involved, speak with your OB-GYN or reproductive endocrinologist.
Testing Your Provider May Discuss
Your provider may recommend:
Pelvic ultrasound
Transvaginal ultrasound
Saline sonohysterogram
MRI
Hysteroscopy
Fertility bloodwork
Iron and ferritin testing
Endometrial evaluation, depending on symptoms
Treatment Options May Include
Treatment depends on the fibroid type, size, symptoms, and fertility goals.
Options may include:
Monitoring
Medication for bleeding control
Myomectomy, which removes fibroids while preserving the uterus
Hysteroscopic removal for certain submucosal fibroids
Laparoscopic or abdominal surgery for larger fibroids
IVF, depending on age, ovarian reserve, and other fertility factors
Some treatments are not recommended when trying to preserve fertility, so make sure your provider knows your pregnancy goals.
Questions to Ask Your Doctor
Bring these questions to your next appointment:
Do I have fibroids?
What type of fibroids do I have?
Where are they located?
How large are they?
Are they affecting the uterine cavity?
Could they interfere with implantation or pregnancy?
Should I have a saline sonogram or hysteroscopy?
Should I check iron or ferritin?
Would removing the fibroid improve my fertility chances?
What treatment options preserve fertility?
Should fibroids be treated before IVF or embryo transfer?
Final Thoughts
Fibroids are common, and many people with fibroids get pregnant.
But some fibroids can affect fertility, especially when they distort the uterine cavity, disrupt the lining, or contribute to heavy bleeding and anemia.
The most important factors are location, size, number, symptoms, and your fertility goals.
If you suspect fibroids could be affecting your ability to conceive, ask for a clear evaluation.
A pelvic ultrasound, saline sonogram, or hysteroscopy may help your provider understand whether fibroids are part of the picture.
Your body is not failing you.
It may simply be giving you information.
And with the right care, testing, and treatment plan, you can move forward with more clarity and confidence.