Does removing fibroids improve fertility and pregnancy success?

This study reviewed clinical studies on the myomectomy and the effects on fertility and pregnancy success.

They found that myomectomy is associated with improved female fertility but it is not clear if it impacts pregnancy success.

Myomas are benign (non-cancerous) tumors, or fibroids, that develop in the uterus. They are very common and affect 70% of women. Myomectomy is a surgical procedure to remove myomas. This alleviates symptoms including pain. 

In clinical trials the location and composition of the myoma varies greatly. Additionally the surgical approach and other clinical symptoms can also vary. The effect of myomas or myomectomies on female fertility is not clear.

This study reviewed clinical trial data to determine if myomas negatively impact fertility and pregnancy success.

88 clinical trials were included in this review. Female fertility was assessed as the clinical pregnancy rate (a women becoming pregnant) and pregnancy success was defined by the live birth rate.

There is not enough evidence to indicate that myomas negatively affect the chance of pregnancy. The characteristics of the myoma, such as size or location, are not associated with an increased risk of pregnancy loss or a reduced likelihood of becoming pregnant. Myomectomy may improve clinical pregnancy rates, however it remains unclear if myomectomy reduces miscarriage rates or improves live birth rates.

This study concluded that myomectomy is associated with improved female fertility but it is not clear if it impacts pregnancy success.

This study found there was insufficient evidence to analyse several parameters – larger randomized control trials are needed. These women had varying levels of fertility; the benefits of myomectomy may be different in infertile women. 

If you have any concerns regarding female fertility please discuss this with your doctor.