Can Uterine Fibroids Affect Fertility?

Uterine fibroids—also known as leiomyomas or myomas—are noncancerous growths that develop in or around the uterus. They are extremely common, affecting up to 70–85% of individuals with a uterus by age 50. While many people experience no symptoms and require no treatment, others may face challenges related to menstruation, pelvic pain, pressure, or reproductive health—including fertility.

The impact of fibroids on fertility depends largely on their size, number, and location. Submucosal fibroids—those that protrude into the uterine cavity—have the strongest association with reduced fertility. Even small submucosal lesions can distort the endometrial lining, interfere with embryo implantation, disrupt blood flow to the endometrium, or cause chronic inflammation—all factors that hinder conception and early pregnancy maintenance.

In contrast, subserosal fibroids (located on the outer surface of the uterus) typically have minimal effect on fertility unless they are very large and compress adjacent structures such as the fallopian tubes or ovaries. Intramural fibroids—embedded within the uterine muscle wall—may impair fertility if they significantly enlarge the uterine cavity or alter contractility patterns necessary for sperm transport or embryo movement.

Evidence suggests that women with untreated submucosal fibroids may have lower natural conception rates, higher miscarriage risk, and decreased success with assisted reproductive technologies like IVF. Surgical removal—particularly hysteroscopic resection for submucosal types—has been associated with improved pregnancy outcomes in multiple studies

It is important to note that most individuals with fibroids conceive without difficulty. Diagnosis often occurs incidentally during routine ultrasound or evaluation for unrelated gynecologic concerns. Not all fibroids warrant intervention; clinical decisions should be guided by symptom burden, reproductive goals, imaging findings, and shared decision-making between patient and provider.

Ongoing research continues to clarify mechanisms linking fibroid biology to infertility—and to refine personalized management strategies. For those planning pregnancy, consultation with a specialist familiar with both fibroid management and reproductive medicine offers the best opportunity to optimize fertility potential.