Can You Get Pregnant With A Fibroid and Fibroids: What to Know

Uterine fibroids are extremely common, and many people first learn they have one while trying to conceive or during pregnancy. The good news: most individuals with fibroids can become pregnant and have healthy pregnancies. Still, size and location matter, and certain fibroids can affect fertility, pregnancy course, and delivery decisions. This guide explains what to know, how fibroids may influence conception and pregnancy, and the treatment options to consider—using information from trusted sources like the NIH, ACOG, and the FDA.

What Are Fibroids?

Fibroids (uterine leiomyomas) are noncancerous growths of the muscle of the uterus. They can be single or multiple and vary widely in size—from seed-like to masses that distort the uterus. Common symptoms include heavy or prolonged periods, pelvic pressure, urinary frequency, constipation, pain during sex, and anemia from blood loss. Many fibroids cause no symptoms and are found incidentally on pelvic exam or ultrasound. Fibroids are most common during the reproductive years and often shrink after menopause. The NIH notes that many people develop fibroids by age 50.[NIH/NICHD] [MedlinePlus]

Can You Get Pregnant With a Fibroid?

Yes—most people with fibroids can conceive naturally. Whether a fibroid affects fertility depends primarily on its location and whether it distorts the uterine cavity. Submucosal fibroids (just under the uterine lining) and cavity-distorting intramural fibroids can interfere with implantation or increase miscarriage risk. Subserosal fibroids (on the outside of the uterus) rarely affect fertility. If you have a fibroid and have been trying to conceive for 6–12 months (sooner if you are 35+ or have symptoms), a fertility evaluation can identify whether the fibroid is contributing and whether treatment could help.[ACOG]

How Fibroids Can Affect Fertility

Fibroids can reduce fertility when they:

• Distort the uterine cavity, making implantation less likely.
• Alter uterine blood flow or cause inflammation in the lining.
• Block the fallopian tube openings (rare but possible near the uterine cornua).
• Contribute to heavy bleeding and anemia, which can affect overall health.

Submucosal fibroids and intramural fibroids that indent the cavity are the most concerning for conception and early pregnancy.[ACOG]

Pregnancy With Fibroids: What to Expect and Possible Risks

Most pregnancies with fibroids progress normally, but risks are somewhat higher depending on fibroid size, number, and location. Potential issues include:

• Pain or “red degeneration,” especially in the second trimester, when a fibroid outgrows its blood supply.
• Miscarriage or bleeding in early pregnancy, particularly with submucosal fibroids.
• Fetal malpresentation (breech) or labor obstruction if a fibroid occupies the lower uterus.
• Preterm contractions or birth in some cases.
• Placental problems (e.g., abruption) and postpartum hemorrhage risk may be modestly increased.
• Higher likelihood of cesarean delivery if fibroids block the birth canal or cause malpresentation.

Importantly, many fibroids do not grow substantially during pregnancy; some remain stable or even shrink after delivery. Your obstetric provider will tailor monitoring to your situation, focusing on fibroid size/location, symptoms, and fetal growth.[MedlinePlus] [ACOG]

How Fibroids Are Evaluated When You’re Trying to Conceive

Evaluation typically starts with a pelvic exam and transvaginal ultrasound to map fibroid number, size, and location. To see whether a fibroid distorts the cavity (where the embryo implants), your clinician may recommend:

• Saline infusion sonohysterography (SIS), which outlines the cavity with sterile saline.
• Hysteroscopy, a camera placed through the cervix to directly visualize and sometimes treat submucosal fibroids.
• Pelvic MRI if the anatomy is complex or prior surgeries make mapping difficult.

It’s also important to check other fertility factors (ovulation, semen analysis, and tubal patency) because fibroids are not always the sole or primary cause of infertility.[CDC]

Treatment Options If You Want Pregnancy

The best approach depends on your symptoms, the fibroid’s characteristics, and your timeline for pregnancy. Options include:

Watchful Waiting

If fibroids are small, not distorting the cavity, and you have no significant symptoms, observation may be appropriate. Many people conceive without intervention.

Myomectomy (Surgical Removal)

For submucosal and cavity-distorting intramural fibroids, myomectomy can improve fertility and reduce miscarriage risk. Techniques include:

• Hysteroscopic myomectomy for submucosal fibroids inside the cavity.
• Laparoscopic or open myomectomy for intramural or subserosal fibroids.

After myomectomy, many clinicians advise waiting about 3–6 months before trying to conceive to allow the uterus to heal. Depending on the depth and number of uterine incisions, a planned cesarean may be recommended in a future pregnancy to reduce uterine rupture risk. Discuss your individualized delivery plan with your obstetrician.[ACOG]

Medications

Medications can help control heavy bleeding or shrink fibroids temporarily but are not fertility treatments and cannot be used during pregnancy. Examples include:

• Gonadotropin-releasing hormone (GnRH) agonists/antagonists to shrink fibroids preoperatively or as short-term symptom control.
• Oral GnRH antagonist combination therapies (e.g., relugolix/elagolix combinations) approved by the FDA for heavy menstrual bleeding due to fibroids; these are contraceptive in effect and are not used when trying to conceive.[FDA overview]

Uterine Artery Embolization (UAE/UFE)

UFE can shrink fibroids and relieve symptoms, but its impact on future fertility is uncertain. Some pregnancies occur after UFE, but professional guidance often favors myomectomy for those prioritizing future pregnancy. Discuss risks and alternatives with a gynecologist experienced in both procedures.[ACOG]

Radiofrequency Ablation (RFA) and Focused Ultrasound

Minimally invasive options like laparoscopic RFA or MRI-guided focused ultrasound may reduce symptoms for select patients, but data on fertility and pregnancy after these procedures remain limited. If you hope to conceive, ask for an individualized risk–benefit discussion and consider options with more robust fertility data (often myomectomy).[ACOG]

About Power Morcellation

During minimally invasive myomectomy or hysterectomy, some surgeons previously used powered devices to fragment tissue for removal. The FDA warns that morcellation can spread an unsuspected uterine cancer in rare cases and has issued guidance to limit use, including containment strategies and patient selection.[FDA Safety Communication] Ask your surgeon how tissue will be removed and what safeguards are in place.

Practical Steps to Improve Your Chances

• Schedule preconception counseling to review fibroid mapping, anemia, and overall health.
• Optimize iron and vitamin D if deficient; treat anemia before pregnancy.
• Maintain a healthy weight, manage blood pressure, and control diabetes if present.
• Time intercourse to ovulation or consider guided fertility care if cycles are irregular.
• Seek evaluation sooner if you are 35+ or have recurrent pregnancy loss, heavy bleeding, or severe pain.

When to Call Your Clinician During Pregnancy

Contact your obstetric provider urgently for severe or persistent abdominal pain, heavy vaginal bleeding, fever, signs of preterm labor (regular contractions, fluid leakage), or decreased fetal movement later in pregnancy. Early evaluation can keep you and your baby safer.

Trusted Sources and Further Reading

• NIH/NICHD: Uterine Fibroids — https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
• MedlinePlus: Uterine Fibroids — https://medlineplus.gov/uterinefibroids.html
• ACOG: Uterine Fibroids FAQ — https://www.acog.org/womens-health/faqs/uterine-fibroids
• CDC: Infertility — https://www.cdc.gov/reproductivehealth/infertility/index.htm
• FDA: Uterine Fibroids—Treatment Landscape — https://www.fda.gov/consumers/consumer-updates/uterine-fibroids-latest-treatments-and-who-they-are-right
• FDA: Power Morcellation Safety Communication — https://www.fda.gov/medical-devices/safety-communications/updated-laparo-power-morcellation-health-care-providers-and-patients-fda-safety-communication

This article is informational and not a substitute for personalized medical advice. If you have fibroids and are planning a pregnancy, speak with a gynecologist or fertility specialist to tailor a plan to your goals.