Uterine Fibroids (Leiomyomas)

Fibroids are the most common benign uterine tumors, affecting up to 70% of women by age 50. Their impact on fertility depends on location: submucosal fibroids (inside the uterine cavity) clearly reduce implantation rates and increase miscarriage risk, and should be removed before IVF. Intramural fibroids (within the muscle wall) may affect outcomes if they distort the cavity. Subserosal fibroids (on the outer surface) generally do not impair fertility.

Removal options include hysteroscopic myomectomy (for submucosal fibroids), laparoscopic or open myomectomy (for intramural/subserosal). Uterine fibroid embolization is generally contraindicated in women who wish to conceive. After myomectomy, a waiting period of 3–6 months is usually recommended to allow healing before IVF.