When you are trying to conceive, being told you have uterine fibroids can feel scary.
You may immediately wonder:
Will I be able to get pregnant?
Do fibroids mean infertility?
Will I need surgery first?
Could fibroids affect IVF?
These are completely normal questions.
But fibroids are also surrounded by a lot of misinformation. Some people are told fibroids always cause infertility. Others are told they must remove every fibroid before trying to conceive. Some assume pregnancy is impossible until the fibroids are gone.
The truth is more nuanced.
Fibroids and fertility can absolutely coexist.
Many people with fibroids conceive naturally, carry healthy pregnancies, and deliver healthy babies. But certain fibroids, especially those that distort the uterine cavity, may affect implantation, pregnancy loss risk, or fertility treatment outcomes.
The key is understanding the type, size, location, and impact of your fibroids before making decisions based on fear.
This article breaks down six common fibroid myths and explains what you really need to know when trying to conceive.
Key Takeaways
Fibroids are common and not all of them affect fertility.
Location matters more than simply having fibroids.
Submucosal fibroids that distort the uterine cavity are more likely to interfere with conception or implantation.
Surgery is not always necessary before trying to conceive.
Many people get pregnant naturally with fibroids.
IVF can still work if fibroids do not distort the uterine cavity.
Fibroids are only one part of the fertility picture, so a complete workup still matters.
Disclaimer
This article is for educational purposes only and is not intended to provide medical advice. Always consult your OB-GYN, reproductive endocrinologist, fertility specialist, or qualified healthcare provider for personalized diagnosis, imaging, treatment, and fertility guidance.
A Quick Refresher: What Are Uterine Fibroids?
Uterine fibroids, also called leiomyomas, are non-cancerous growths made of muscle tissue.
They grow in or around the uterus and can vary widely in size, shape, number, and location.
Some fibroids are tiny and cause no symptoms.
Others can be large, painful, or disruptive to the uterine cavity.
Common Types of Fibroids
Fibroids are often described based on where they grow.
Submucosal Fibroids
These grow into the uterine cavity.
They are the type most likely to affect fertility because they may distort the space where an embryo needs to implant.
Intramural Fibroids
These grow within the muscular wall of the uterus.
They may or may not affect fertility depending on their size and whether they press into or distort the uterine cavity.
Subserosal Fibroids
These grow on the outer surface of the uterus.
They are usually less likely to interfere with implantation because they are outside the uterine cavity.
Pedunculated Fibroids
These are attached to the uterus by a stalk.
They may grow inside or outside the uterus depending on their location.
Fibroids are very common, especially as people get older. But common does not always mean dangerous, and having fibroids does not automatically mean you cannot get pregnant.
Myth 1: All Fibroids Cause Infertility
The Myth
If you have fibroids, you will have trouble getting pregnant.
The Truth
Most fibroids do not cause infertility.
Whether fibroids affect fertility depends mainly on:
Location
Size
Number
Whether they distort the uterine cavity
Whether they block the fallopian tubes
Whether they affect blood flow to the uterine lining
Whether they are linked with pregnancy loss or failed transfers
Submucosal fibroids are usually the biggest concern because they grow into the uterine cavity.
Fibroids that distort the cavity may interfere with implantation or increase miscarriage risk.
But small fibroids that do not affect the uterine cavity may have little to no impact on fertility.
When Fibroids May Affect Fertility
Fibroids may interfere with fertility if they:
Change the shape of the uterine cavity
Block the fallopian tubes
Interfere with embryo implantation
Affect blood flow to the uterine lining
Contribute to inflammation or uterine contractility changes
Are linked with recurrent pregnancy loss
Make embryo transfer technically difficult
What to Ask Your Provider
What type of fibroid do I have?
Where is it located?
Is it distorting the uterine cavity?
Could it affect implantation?
Could it block a fallopian tube?
Does it need treatment before trying to conceive?
Myth 2: You Must Remove All Fibroids Before Trying to Conceive
The Myth
Every fibroid should be removed before pregnancy or IVF.
The Truth
Fibroid removal, called myomectomy, is not always necessary.
In some cases, surgery can improve fertility outcomes.
In other cases, surgery may not provide meaningful benefit and could delay treatment or create scar tissue.
The decision depends on whether the fibroid is actually affecting the uterus or fertility pathway.
Surgery May Be Considered If:
A fibroid grows into the uterine cavity
The uterine cavity is distorted
Fibroids are linked with recurrent pregnancy loss
Fibroids are associated with failed embryo transfers
Fibroids are large and affecting anatomy
Fibroids are causing heavy bleeding, severe pain, or pressure symptoms
Fibroids make embryo transfer difficult
Surgery May Not Be Needed If:
Fibroids are small
Fibroids are outside the uterine cavity
The uterine cavity is normal
There are no major symptoms
There is no evidence the fibroids are affecting fertility
Why This Matters
A “remove everything” approach is not always best.
A fertility-focused plan should weigh the benefits of surgery against the risks, recovery time, scar tissue, age, ovarian reserve, IVF plans, and pregnancy goals.
What to Ask Your Provider
Do my fibroids need removal before trying to conceive?
Would surgery improve my chances?
What are the risks of myomectomy?
How long would I need to wait before trying after surgery?
Could surgery delay IVF or pregnancy planning?
Is monitoring a reasonable option?
Myth 3: You Cannot Get Pregnant With Fibroids
The Myth
Fibroids make natural pregnancy impossible.
The Truth
Many people get pregnant naturally with fibroids.
In fact, some people do not even know they have fibroids until an ultrasound during pregnancy.
Fibroids are not automatically a barrier to conception.
The impact depends on where they are and whether they interfere with the uterine cavity, fallopian tubes, or implantation environment.
Fibroids May Be Less Likely to Affect Conception When They Are:
Subserosal
Small
Not distorting the uterine lining
Not blocking the tubes
Not causing major bleeding or pain
Located away from the reproductive pathway
Fertility Is Bigger Than Fibroids
Even when fibroids are present, fertility also depends on:
Age
Egg quality
Ovulation
Sperm health
Fallopian tube health
Uterine lining
Hormone balance
Endometriosis or adenomyosis
Overall reproductive health
What to Ask Your Provider
Is natural conception realistic in my case?
How long should we try before treatment?
Are my tubes open?
Am I ovulating regularly?
Should my partner have a semen analysis?
Are the fibroids the main issue, or just one finding?
Myth 4: Fibroids Always Get Worse During Pregnancy
The Myth
Fibroids always grow during pregnancy and always cause complications.
The Truth
Fibroids can grow during pregnancy, but they do not always grow.
Some stay the same size.
Some shrink.
Some grow early in pregnancy and then stabilize later.
Pregnancy hormones may influence fibroid growth, but every person’s experience is different.
Possible Fibroid Changes During Pregnancy
During pregnancy:
Some fibroids may grow in the first trimester.
Many remain stable.
Some decrease in size later.
Some shrink after delivery as hormone levels change.
Some may cause pain if they outgrow their blood supply.
Possible Pregnancy Concerns With Fibroids
Depending on size and location, fibroids may be associated with:
Pain
Bleeding
Placental concerns
Preterm labor risk
Breech position
Cesarean delivery risk
Growth monitoring needs
But not everyone with fibroids experiences complications.
Many pregnancies with fibroids are monitored and progress well.
What to Ask Your Provider
Are my fibroids likely to affect pregnancy?
Will I need extra ultrasounds?
Could fibroids affect baby’s position?
Could they increase bleeding or pain?
What symptoms should I report during pregnancy?
Myth 5: IVF Will Not Work If You Have Fibroids
The Myth
Fibroids automatically make IVF fail.
The Truth
IVF can be successful with fibroids, especially when the uterine cavity is not affected.
The biggest concern is whether the fibroid distorts the endometrial cavity, where the embryo needs to implant.
Submucosal fibroids or cavity-distorting intramural fibroids are more likely to reduce implantation and live birth rates.
Fibroids that do not affect the cavity may have less impact on IVF outcomes.
Why Cavity Evaluation Matters
Before IVF or embryo transfer, your fertility specialist may recommend a closer look at the uterine cavity.
Testing may include:
Saline sonohysterogram, also called SHG
Hysteroscopy
Transvaginal ultrasound
Pelvic MRI in select cases
These tests can help determine whether fibroids are affecting the space where implantation needs to happen.
What to Ask Your IVF Doctor
Do my fibroids distort the uterine cavity?
Should I have an SHG before transfer?
Would hysteroscopy help?
Should fibroids be removed before embryo transfer?
Could fibroids affect implantation or miscarriage risk?
Is it safe to proceed with IVF first and decide about transfer later?
Myth 6: Fibroids Are the Only Thing Holding You Back
The Myth
If you have fibroids, they must be the reason you are not pregnant.
The Truth
Fibroids may be part of the fertility picture, but they are not always the whole picture.
It is possible to have fibroids and another fertility factor at the same time.
Other Fertility Factors to Consider
A complete fertility workup may evaluate:
Egg quality
Ovarian reserve
Ovulation
Sperm count, motility, and morphology
Tubal blockage
Endometriosis
Adenomyosis
Thyroid function
Prolactin levels
PCOS
Uterine polyps
Lining development
Recurrent pregnancy loss factors
Why This Matters
If fibroids are blamed too quickly, other important causes may be missed.
A personalized fertility plan should look at the full reproductive picture, not just one ultrasound finding.
What to Ask Your Provider
Are my fibroids actually affecting fertility?
What other testing should we do?
Have we evaluated ovulation, tubes, sperm, and ovarian reserve?
Could endometriosis or adenomyosis also be involved?
What is the most likely reason we are not pregnant yet?
Key Takeaways: Fibroid Myths vs. Reality
Myth | Reality |
|---|---|
All fibroids cause infertility | Only some fibroids affect fertility based on size, location, and cavity distortion |
You must remove fibroids before pregnancy | Surgery is only needed in certain cases |
You cannot conceive naturally with fibroids | Many people with fibroids get pregnant naturally |
Fibroids always grow during pregnancy | Some grow, many stay stable, and some shrink |
IVF will not work with fibroids | IVF can still work if the uterine cavity is unaffected |
Fibroids are the only fertility issue | Many other factors can influence fertility |
How to Advocate for the Right Fibroid Plan
The best fibroid plan is not based on fear.
It is based on details.
Ask About Fibroid Type and Location
Ask your provider to explain:
Is the fibroid submucosal, intramural, subserosal, or pedunculated?
Is it inside, near, or outside the uterine cavity?
How large is it?
How many fibroids are there?
Is it growing?
Ask Whether the Uterine Cavity Is Affected
This is one of the most important fertility questions.
Ask:
Is my uterine cavity distorted?
Is the endometrial lining affected?
Would SHG or hysteroscopy give more information?
Could this fibroid interfere with implantation?
Ask About Treatment Options
Depending on your situation, your provider may discuss:
Monitoring
Medication for symptoms
Myomectomy
Hysteroscopic removal for certain submucosal fibroids
Laparoscopic or robotic myomectomy
Open myomectomy for larger or complex cases
IVF timing
Pregnancy monitoring
Not all fibroid treatments are appropriate for people actively trying to conceive, so always discuss fertility goals first.
Ask About the Bigger Fertility Picture
Fibroids are only one part of the equation.
Ask whether you also need:
AMH testing
Antral follicle count
FSH and estradiol
Thyroid labs
Prolactin
Tube testing
Semen analysis
Evaluation for endometriosis or adenomyosis
Recurrent pregnancy loss testing, if relevant
Questions to Ask Your Doctor
Bring these questions to your next appointment:
What type of fibroid do I have?
Where is it located?
How big is it?
Is it distorting my uterine cavity?
Could it affect implantation?
Could it increase miscarriage risk?
Do I need an SHG, MRI, or hysteroscopy?
Should I remove it before trying to conceive?
If surgery is recommended, what type?
How long would I need to wait after surgery before trying?
Can I try naturally first?
Would IVF still work with this fibroid?
Are there other fertility factors we should evaluate?
Final Thoughts
Fibroids are common, but they do not define your fertility.
Having fibroids does not automatically mean you cannot get pregnant.
It does not automatically mean you need surgery.
And it does not automatically mean IVF will fail.
The real question is whether your specific fibroid is affecting the uterine cavity, implantation environment, fallopian tubes, symptoms, or pregnancy risk.
That answer requires good imaging, a complete fertility workup, and a care team that looks at your full picture.
You deserve a plan built around your body, not fear.
Stay informed.
Ask specific questions.
Get clarity on the location and impact of your fibroids.
And remember: your fertility story is still being written.