Fibroids and IVF
Why This Matters
If you're preparing for IVF and have been told you have fibroids, you may feel as though you've been faced with yet another obstacle.
You might be wondering:
Will my fibroids stop IVF from working?
Do they need to be removed first?
Should I delay treatment?
Have my chances of success become much lower?
These are completely understandable concerns.
The reassuring news is that many women with fibroids have successful IVF treatment and go on to have healthy pregnancies.
Whether fibroids affect IVF depends largely on their size, location and whether they change the shape of the uterine cavity.
Quick Summary
Many women with fibroids have successful IVF treatment.
Not all fibroids reduce IVF success rates.
Fibroids that distort the inside of the uterus are most likely to affect implantation.
Some women may benefit from having fibroids treated before IVF.
Treatment decisions should always be individualised.
Your fertility specialist will consider all aspects of your fertility, not just your fibroids.
Can You Have IVF If You Have Fibroids?
Yes.
Having fibroids does not automatically mean IVF will fail.
Many women with fibroids successfully undergo IVF and have healthy babies.
Whether treatment is recommended before IVF depends on:
where the fibroids are located
their size
how many fibroids are present
whether they distort the uterine cavity
your age
previous IVF attempts
other fertility factors
How Can Fibroids Affect IVF?
For IVF to be successful, an embryo needs to implant into the lining of the uterus.
Some fibroids can interfere with this process.
Researchers believe they may:
distort the uterine cavity
reduce blood flow to the uterine lining
affect implantation
alter the normal contractions of the uterus
change the environment needed for embryo development
However, many fibroids do none of these things.
Which Fibroids Are Most Likely to Affect IVF?
Submucosal Fibroids
These grow into the uterine cavity.
They have the greatest impact on IVF because they can interfere with implantation.
Many fertility specialists recommend removing these fibroids before IVF.
Intramural Fibroids
Fibroids within the muscular wall of the uterus may affect IVF if they are large or distort the uterine cavity.
Smaller intramural fibroids that do not affect the cavity may have little or no impact.
Research is ongoing, and recommendations are made on an individual basis.
Subserosal Fibroids
Fibroids on the outside of the uterus rarely affect IVF success because they usually do not interfere with implantation.
Treatment is often unnecessary unless they are causing significant symptoms.
Should Fibroids Be Removed Before IVF?
Not always.
Removing fibroids is not routinely recommended for every woman.
Your fertility specialist may suggest treatment if:
a fibroid distorts the uterine cavity
repeated IVF cycles have been unsuccessful
the fibroid is very large
symptoms such as heavy bleeding or pain are affecting your health
The decision balances the potential benefits of surgery against the time needed to recover before starting IVF.
What Happens If Surgery Is Recommended?
The most common operation is a myomectomy, which removes fibroids while preserving the uterus.
Depending on the fibroids, this may be performed:
through the cervix (hysteroscopic myomectomy)
by keyhole surgery (laparoscopic or robotic)
through open abdominal surgery
Your fertility specialist will advise how long you should wait before starting IVF after surgery.
Will Removing Fibroids Guarantee IVF Success?
No.
Removing fibroids may improve the chances of implantation in selected women, but it cannot guarantee pregnancy.
IVF success depends on many factors, including:
egg quality
sperm quality
embryo quality
age
uterine health
other medical conditions
Fibroids are only one part of the overall picture.
What If My Specialist Recommends Leaving Them Alone?
This can feel confusing.
Many women assume that every fibroid should be removed before IVF.
In reality, unnecessary surgery carries its own risks, including scar tissue formation and delays to fertility treatment.
If your specialist recommends monitoring your fibroids rather than removing them, it's usually because they believe the potential risks of surgery outweigh the likely benefits.
Don't be afraid to ask why they have made that recommendation.
What Does This Mean for You?
If you're planning IVF and have fibroids, it's understandable to feel anxious.
The important thing to remember is that not all fibroids reduce the chances of IVF success, and many women with fibroids achieve healthy pregnancies through fertility treatment.
Your fertility specialist will look at your overall fertility, not just your fibroids.
Together, you can decide whether monitoring, treatment or proceeding directly to IVF is the most appropriate option for your individual circumstances.
You Are Not Alone
Starting IVF can feel emotionally and physically exhausting.
Being told you also have fibroids may leave you feeling as though the goalposts have moved yet again.
If that's how you're feeling, you're not alone.
Many women begin IVF with fibroids and go on to have successful treatment.
Try not to compare your journey with anyone else's. Your fertility specialist is looking at your uterus, your fertility history and your circumstances to create the treatment plan that's right for you.
Questions to Ask Your Doctor
Are my fibroids likely to affect IVF success?
Do they distort the uterine cavity?
Would removing my fibroids improve my chances?
What are the risks of surgery before IVF?
How long would I need to wait after surgery before starting treatment?
Are there any other fertility factors affecting my chances?
Why do you recommend treating—or not treating—my fibroids?
Myth vs Fact
Myth
Fact
Having fibroids means IVF won't work.
Many women with fibroids have successful IVF treatment.
Every fibroid should be removed before IVF.
Treatment is only recommended when fibroids are likely to affect success or cause significant symptoms.
Removing fibroids guarantees pregnancy.
Surgery may improve the chances in some women but cannot guarantee IVF success.
Only large fibroids matter.
A small fibroid inside the uterine cavity may have a greater impact than a larger one on the outside of the uterus.
When to Seek Medical Advice
If you're planning IVF and have fibroids, contact your fertility clinic if:
you develop new or worsening pelvic pain
you experience unusually heavy bleeding
your symptoms change significantly while waiting for treatment
you have concerns about your treatment plan or need further explanation
During IVF treatment, always follow the advice of your fertility clinic and report any symptoms that concern you promptly.
Your Next Step
If you're preparing for IVF:
Ask exactly where your fibroids are located.
Find out whether they change the shape of the uterine cavity.
Ask why your specialist recommends surgery—or why they don't.
Make a note of any questions before your next appointment.
Remember that fibroids are only one factor influencing IVF success.
Understanding your individual situation will help you make informed decisions alongside your fertility team.
Key Takeaways
Many women with fibroids have successful IVF treatment.
Fibroids do not automatically reduce IVF success.
Fibroids inside the uterine cavity are most likely to affect implantation.
Surgery is only recommended when it's likely to improve outcomes.
IVF success depends on many different factors, not fibroids alone.
Treatment decisions should always be individualised.
Frequently Asked Questions
Can I have IVF if I have fibroids?
Yes. Many women with fibroids undergo successful IVF treatment and have healthy pregnancies.
Which fibroids affect IVF the most?
Submucosal fibroids, because they distort the uterine cavity and may interfere with implantation.
Will I need surgery before IVF?
Not necessarily. Your fertility specialist will decide whether surgery is likely to improve your chances based on the size and location of your fibroids.
Does removing fibroids guarantee IVF success?
No. While surgery may improve implantation in some women, IVF success depends on many factors.
Should I delay IVF to remove my fibroids?
Only if your fertility specialist believes the benefits outweigh the risks and delay. This decision should be made on an individual basis.
References
National Institute for Health and Care Excellence (NICE). Fertility Problems: Assessment and Treatment (NG156).
European Society of Human Reproduction and Embryology (ESHRE). Guidelines on infertility and assisted reproduction.
American Society for Reproductive Medicine (ASRM). Removal of Myomas in Asymptomatic Patients to Improve Fertility and/or Reduce Miscarriage Rate.
American College of Obstetricians and Gynecologists (ACOG). Uterine Fibroids.
Stewart EA, et al. Uterine Fibroids. Nature Reviews Disease Primers.
Bulun SE. Uterine Fibroids. New England Journal of Medicine.