Ms. Guo, a white-collar worker in her 30s, has not yet had children and was planning to conceive in the second half of the year. Unfortunately, a recent company physical examination revealed uterine fibroids. She is very worried and has three urgent questions: Will uterine fibroids affect her ability to conceive? Should she use contraception now? Should she have surgery to remove them before trying to get pregnant?
Patients with small fibroids can become pregnant while having the fibroids.
Uterine fibroids are a common benign tumor in women. They can be single, but are often multiple, meaning several tumors can grow simultaneously within the uterus. If a tumor grows outward close to the surface, it is called a subserosal fibroid; if it grows in the middle, it is called an intramural fibroid; and if it grows into the uterine cavity, it is called a submucosal fibroid. Fibroids can also be pedunculated, but more often they are sessile. Uterine fibroids vary in shape and size, and can cause the uterus to lose its normal shape and become irregular. If a fibroid grows at the uterine horn, it can block the fallopian tube opening or cause compression and obstruction of the fallopian tubes, affecting conception. Fibroids can also alter the shape of the uterine cavity, affecting the implantation of a fertilized egg.
Therefore, uterine fibroid patients often experience infertility, which is commonly known as "having a tumor and not being able to have children." However, not everyone with uterine fibroids is unable to get pregnant.
Experts point out that different types of fibroids have different effects on pregnancy, so they must be treated differently. In clinical practice, it is generally believed that if the fibroid is an intramural or subserosal fibroid with a diameter of no more than 4 cm, the patient can choose to become pregnant with the fibroid. However, patients need to know that during pregnancy, due to the rapid changes in the blood supply to the uterus, the fibroid may grow rapidly, potentially leading to ischemia and red degeneration, or, if the uterus changes position, a subserosal fibroid may twist. Both of these situations can cause severe abdominal pain, leading to miscarriage or premature birth.
Contraception recommendation: Male condoms
To avoid pregnancy with fibroids, women should undergo a thorough gynecological examination before pregnancy to screen for fibroids. Early detection helps reduce pregnancy risks. Women diagnosed with uterine fibroids before pregnancy should use effective contraception and should not be careless.
Current contraceptive methods include condoms, birth control pills, tubal ligation sterilization, and intrauterine devices (IUDs).
However, experts believe that male contraceptive devices or vaginal diaphragms are the best options, and oral contraceptives are generally not recommended. This is because most contraceptives contain hormones, and prolonged use can have a significant impact on the endocrine system. If estrogen levels rise continuously due to contraceptives, it may stimulate the accelerated growth of uterine fibroids, which is detrimental to the condition. Patients with uterine fibroids should avoid medications or supplements containing estrogen, such as soy products, royal jelly, breast enhancement and weight loss drugs, and contraceptives.
In addition, intrauterine devices (IUDs) are also unsuitable. Because uterine fibroids can enlarge the uterine cavity, IUDs can easily shift and become ineffective. Furthermore, if the patient has submucosal fibroids, the insertion of an IUD can stimulate the fibroids, causing them to grow rapidly and leading to persistent bleeding.
As for tubal ligation, it is only applicable to women who have already given birth.
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