Fibroids and Miscarriage
Why This Matters
If you've experienced a miscarriage and have been told you have fibroids, it's natural to wonder whether the two are connected.
You may be asking yourself:
Did my fibroids cause my miscarriage?
Will it happen again?
Should I have my fibroids removed before trying for another baby?
These are understandable questions, but the answers are rarely straightforward.
While some fibroids can increase the risk of miscarriage, many women with fibroids have healthy pregnancies and healthy babies. Just as importantly, most miscarriages are not caused by fibroids.
Understanding when fibroids may play a role can help you have informed discussions with your healthcare team and avoid carrying unnecessary guilt.
Quick Summary
Most women with fibroids do not experience miscarriage because of them.
The location of a fibroid is often more important than its size.
Fibroids that distort the uterine cavity carry the greatest risk.
Most miscarriages are caused by chromosomal abnormalities in the developing embryo, not fibroids.
Your healthcare team will consider your individual circumstances before recommending treatment.
Many women with fibroids go on to have successful pregnancies.
Can Fibroids Cause Miscarriage?
The answer is sometimes, but not always.
Research suggests that some fibroids can increase the risk of miscarriage, particularly if they alter the shape of the inside of the uterus.
However, many women with fibroids never experience pregnancy loss.
It's important to remember that miscarriage is common.
Around 1 in 4 recognised pregnancies ends in miscarriage, and the majority are caused by problems with the chromosomes of the developing embryo rather than anything the mother did—or didn't do.
Which Fibroids Carry the Greatest Risk?
Not all fibroids affect pregnancy in the same way.
Submucosal Fibroids
These grow into the uterine cavity.
They are the type most strongly linked with miscarriage because they may:
interfere with implantation
reduce the available space for the pregnancy
affect blood flow to the uterine lining
change the environment needed for early pregnancy
Intramural Fibroids
Fibroids within the muscular wall of the uterus may increase miscarriage risk if they become large enough to distort the uterine cavity.
Smaller intramural fibroids that do not affect the cavity appear to have much less impact.
Subserosal Fibroids
Fibroids on the outside of the uterus rarely increase miscarriage risk because they do not usually affect the inside of the womb where the pregnancy develops.
Why Might Fibroids Increase the Risk?
Researchers believe fibroids may contribute by:
changing the shape of the uterine cavity
reducing blood flow to the lining of the uterus
interfering with implantation
affecting placental development
causing changes in the way the uterus contracts
Research is ongoing, and scientists are still learning exactly how these changes affect pregnancy.
Are Fibroids Usually the Cause?
Usually not.
Most miscarriages occur because the embryo has a chromosome abnormality that prevents normal development.
Other possible causes include:
age-related changes in egg quality
hormonal problems
thyroid disease
antiphospholipid syndrome
uterine abnormalities
uncontrolled diabetes
lifestyle factors such as smoking
sometimes no cause is ever found
Even if you have fibroids, they may simply be an incidental finding rather than the reason for the miscarriage.
What If I've Had More Than One Miscarriage?
If you've experienced two or more miscarriages, your healthcare provider may recommend further investigations.
These may include:
ultrasound scanning
hysteroscopy
blood tests
assessment of the uterine cavity
investigation for other possible causes of recurrent pregnancy loss
If a fibroid is thought to be contributing, treatment may be discussed.
Should Fibroids Be Removed Before Pregnancy?
Not always.
Many women with fibroids do not need surgery.
However, your doctor may recommend a myomectomy if:
a fibroid significantly distorts the uterine cavity
repeated miscarriages may be related to the fibroid
fertility treatment has been unsuccessful and the fibroid is thought to be contributing
The decision is individual and balances the potential benefits of surgery against the risks.
What Happens If I Become Pregnant Again?
Most women who become pregnant after a miscarriage go on to have healthy pregnancies.
If you have fibroids, your healthcare team may recommend:
an early pregnancy scan
additional monitoring if needed
routine antenatal care tailored to your circumstances
The exact plan depends on the size and location of your fibroids and your previous pregnancy history.
What Does This Mean for You?
If you've had a miscarriage, it's understandable to search for a reason.
Finding out you also have fibroids may seem to provide an answer, but in many cases it isn't that simple.
While some fibroids can increase miscarriage risk, most miscarriages are not caused by fibroids, and many women with fibroids go on to have healthy pregnancies.
Rather than assuming your fibroids were responsible, it's important to discuss your individual situation with your healthcare provider and ensure that all possible causes are considered.
You Are Not Alone
After a miscarriage, many women replay every detail of their pregnancy, searching for something they could have done differently.
If you've recently been told you have fibroids, it's easy to blame them—or even blame yourself.
Please remember that miscarriage is rarely caused by one single factor, and in many cases there is nothing you could have done to prevent it.
You deserve clear answers, compassionate care and the opportunity to ask questions without feeling rushed.
Questions to Ask Your Doctor
Could my fibroids have contributed to my miscarriage?
Where are my fibroids located?
Do they distort the uterine cavity?
Should I have further investigations before trying again?
Would removing my fibroids improve my chances of a successful pregnancy?
Are there any other possible causes that should be investigated?
When is it safe for me to try to conceive again?
Myth vs Fact
Myth
Fact
Every miscarriage in a woman with fibroids is caused by the fibroids.
Most miscarriages are caused by chromosomal abnormalities, not fibroids.
All fibroids increase miscarriage risk.
The location of the fibroid is usually more important than its size.
If I've had one miscarriage, I'll definitely have another.
Most women go on to have healthy pregnancies after a miscarriage.
Every woman with fibroids should have surgery before pregnancy.
Surgery is only recommended in selected situations where it's likely to improve outcomes.
When to Seek Urgent Medical Advice
If you are pregnant and have fibroids, seek urgent medical advice if you experience:
heavy vaginal bleeding
severe abdominal pain
passing large clots or pregnancy tissue
fever or chills
leaking fluid from the vagina
severe dizziness or fainting
any symptom that makes you feel your pregnancy may be at risk
If you've already been diagnosed with a miscarriage and develop heavy bleeding, severe pain, a fever or a foul-smelling vaginal discharge, seek medical attention immediately, as these symptoms may indicate complications that require prompt treatment.
Your Next Step
If you've experienced a miscarriage and have fibroids:
Ask for an explanation of where your fibroids are located.
Find out whether they are likely to affect future pregnancies.
If you've had recurrent miscarriages, ask whether further investigations are appropriate.
Remember that one miscarriage does not necessarily mean you'll have another.
Write down any questions before your next appointment so you feel prepared to discuss your options.
Key Takeaways
Most women with fibroids have successful pregnancies.
Some fibroids can increase miscarriage risk, particularly those that distort the uterine cavity.
Most miscarriages are caused by chromosomal abnormalities rather than fibroids.
Surgery is not necessary for every woman with fibroids.
Your treatment should always be based on your individual circumstances.
If you've experienced recurrent miscarriages, further investigations may be appropriate.
Frequently Asked Questions
Did my fibroids cause my miscarriage?
Not necessarily. Most miscarriages are caused by chromosomal abnormalities rather than fibroids, although some fibroids may increase the risk depending on their location.
Which fibroids are most likely to increase miscarriage risk?
Submucosal fibroids, and some larger intramural fibroids that distort the uterine cavity.
Should I have my fibroids removed before trying again?
Not always. Your healthcare provider will assess whether surgery is likely to improve your chances of a healthy pregnancy.
Can I have a healthy baby after a miscarriage if I have fibroids?
Yes. Many women with fibroids have healthy pregnancies after experiencing a miscarriage.
Should I ask for more tests after a miscarriage?
If you've had recurrent miscarriages or your healthcare provider believes your fibroids may be contributing, further investigations may be recommended.
References
National Institute for Health and Care Excellence (NICE). Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management.
Royal College of Obstetricians and Gynaecologists (RCOG). Recurrent Miscarriage and Fibroids: Information for You.
American College of Obstetricians and Gynecologists (ACOG). Early Pregnancy Loss and Uterine Fibroids.
European Society of Human Reproduction and Embryology (ESHRE). Guideline on Recurrent Pregnancy Loss.
Stewart EA, et al. Uterine Fibroids. Nature Reviews Disease Primers.
Bulun SE. Uterine Fibroids. New England Journal of Medicine.