A woman may have fertility problems for a variety of reasons. The key is to understand why you are not conceiving and then discuss the course of action with your fertility consultant. 

Tests will help your consultant see if you have any of the following conditions:

PCOS (polycystic ovary syndrome), endometriosis, blocked fallopian tubes, a thyroid issue, difficulty ovulating, scarring of the cervix or vagina, tubal disease, antibodies to sperm, age, prolactinoma, polyps and fibroids.

In this fact sheet, we learn more about Uterine fibroids



Occurring in various parts of the uterus, fibroids tend to be small in size when they first appear, gradually growing bigger over time. There are reports of incidences where fibroids have been as large as a water melon. In most cases, fibroid tumours that impact fertility are those impinging on the endometrial cavity


Depending on the fibroid tumour size, a diagnosis is determined with a quick vaginal test or internal vaginal ultrasound. Large fibroid tumours can sometimes impinge on the endometrial cavity, which is identified by a hysteroscopy or hysterosonogram. If there is uncertainty when diagnosing the presence of fibroid tumours or the similar adenomyosis, an MRI scan will clarify this.


The growth of fibroid tumours can affect as many as 40% of females who have a monthly menstruation cycle. The hormone estrogen is responsible for the fibroids increasing in size, although there is also thought to be a genetic factor involved.

Signs and Symptoms

There are patients with fibroid tumours that report no symptoms whatsoever; however the majority of those with the condition tend to describe similar discomfort. The most common symptoms are heavy, painful periods, constipation, pain during intercourse and increased urination. When a fibroid becomes infected there is usually an increased amount of pain and the possibility of experiencing fever and chills.


Removal of fibroids is usually performed if they impinge on the endometrial cavity, or before fertility treatment begins. A surgical procedure known as myomectomy is the most effective method of treatment. Fibroids of considerable size or awkward to access will usually require removal by means of a surgical opening on the abdomen and can take up to two months to recover. A laparoscopy is less invasive, with only a couple of days required to fully recover. This procedure is ideal for the removal of reachable and small fibroids. Hysteroscopic surgery may be considered as an option when most of the fibroid tumour is aggravating the endometrial cavity. This can postpone fertility treatment as a follow-up hysteroscopy is carried out several months after the initial surgery.

Further treatment options for fibroid tumours include medications prescribed by your GP. An effective drug is Lupron, which imitates the menopause by eliminating production of the female hormone estrogen. Fibroids significantly decrease in size when deprived of estrogen, resulting in a reduction of discomfort and symptoms. This medication can only be prescribed for a maximum of six months and is intended to provide short-term relief only.





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