Here's a number that might surprise you: by the age of 50, up to 80% of women will have uterine fibroids. Most won't know it. Many won't be affected. But for a significant number — perhaps 1 in 4 — fibroids are a silent saboteur: causing heavy bleeding, distorting the uterine cavity, blocking tubes, and quietly making conception harder month after month.
The tricky part? Fibroids don't always announce themselves. They can grow slowly, asymptomatically, for years — until the day you try to get pregnant and suddenly you're being told your uterus 'looks a bit bulky' on an ultrasound, or a submucosal fibroid has been narrowing your uterine cavity without any symptoms at all.
This free Fibroid Impact Quiz was built by India IVF Fertility's clinical team to help you assess whether your symptoms — and your fertility story — could be connected to fibroids you may not even know you have.
3 minutes. No blood test. Instant result. Finally, some clarity.
Uterine fibroids (medically: uterine leiomyomas) are benign (non-cancerous) tumours of the uterine smooth muscle. They are completely non-malignant — their significance is almost entirely about what they do to your uterus's function, not what they are in terms of cancer risk.
They range from the size of a pea to the size of a large grapefruit. A single uterus can harbour one or dozens. They are driven largely by estrogen — which is why they grow during the reproductive years and shrink after menopause.
Extremely common. Prevalence studies in India show that 20–40% of women of reproductive age have detectable fibroids on ultrasound. The majority are asymptomatic and require no intervention. But the subset that cause symptoms — heavy bleeding, pelvic pain, pressure, or fertility problems — is clinically significant and absolutely treatable.
The hallmark symptom of submucosal and large intramural fibroids. The fibroid distorts the inner surface of the uterus, increasing the surface area that bleeds during menstruation and disrupting the normal clotting mechanisms. Women describe soaking through protection, passing large clots, and periods lasting 8–10+ days.
Large fibroids push on surrounding structures. A fibroid pressing on the bladder creates urinary urgency. One pressing on the bowel causes constipation or straining. The general sensation is of heaviness or fullness in the lower abdomen — sometimes constant, sometimes only during menstruation.
Anterior fibroids (growing toward the bladder) compress it, reducing its capacity and causing the constant urge to urinate. In some cases, particularly large anterior fibroids can cause urinary retention — an inability to empty the bladder completely. If you're waking up multiple times at night to urinate without a UTI, fibroids warrant investigation.
Posterior fibroids — growing toward the back of the uterus — press on the lumbar spine and sacral nerves. The result is a deep, chronic lower back ache that often worsens during menstruation and doesn't respond to standard back pain treatment. Many women carry this diagnosis of 'muscular back pain' for years before the fibroid is found.
Very large fibroids — or multiple fibroids in aggregate — can make the uterus the size of a 12–16 week pregnancy. Women describe looking 'bloated all the time' or noticing their clothes don't fit the same way. An abdomen that feels firm and enlarged, particularly toward the midline, should be investigated.
Submucosal fibroids protruding into the uterine cavity are associated with recurrent miscarriage. They disrupt the blood supply to the developing embryo and interfere with implantation. In some studies, surgical removal of submucosal fibroids reduces miscarriage rate by up to 50% in women with recurrent loss.
Fibroids can impair fertility through multiple mechanisms — cavity distortion, tubal obstruction, impaired endometrial blood flow, and local inflammatory changes. If you've been trying to conceive for over 6 months with unexplained failure, and you haven't had a uterine cavity assessment (SIS or hysteroscopy), fibroids may be an undetected factor.
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This is the most critical mechanism. Even a small (1.5cm) submucosal fibroid bulging into the cavity creates an irregular surface that an embryo cannot implant on properly. It is like trying to plant a seed on uneven, rocky ground. The embryo often fails to implant or implants poorly and miscarries.
Fibroids at the cornual region (where the fallopian tube enters the uterus) can compress the tubal ostium, preventing sperm from reaching the egg or the fertilized embryo from reaching the uterus. This can cause ectopic pregnancy as well as infertility.
Large intramural fibroids alter uterine blood flow patterns. They can redirect blood away from the endometrium (inner lining), impairing its receptivity to implantation. A thinned or poorly perfused endometrium is a hostile environment for an incoming embryo.
Fibroids produce local inflammatory mediators and may alter estrogen metabolism within the uterine environment. These changes impair sperm transport, fertilization rates in some studies, and the molecular 'stickiness' of the endometrium to an embryo.
If you already have an ultrasound report mentioning fibroids, here is a quick guide:
If your report says 'bulky uterus' without specifying fibroid type or size — a detailed transvaginal ultrasound or SIS (saline infusion sonohysterography) is needed for proper characterization.
Not every fibroid needs treatment. Small, asymptomatic, subserosal or intramural fibroids with no cavity involvement — particularly in women with no fertility concerns — can often be monitored with annual ultrasound.
For submucosal fibroids. A fine camera is introduced through the cervix, and the fibroid is removed without any incision. It is a day procedure with recovery of 2–3 days.
For intramural and subserosal fibroids. Keyhole surgery to remove fibroids through 3–4 small incisions. The uterus is carefully repaired to maintain integrity for pregnancy.
Most women can start IVF 3–6 months after myomectomy. Women with submucosal fibroid removal who then undergo IVF have significantly better embryo implantation and pregnancy rates.
Your symptom profile doesn't strongly suggest fibroids affecting fertility. However, if you've been trying to conceive without success, a baseline pelvic ultrasound is always worthwhile.
Your profile suggests possible fibroids. A transvaginal ultrasound and specialist review will clarify whether intervention is needed before or alongside fertility treatment.
Your symptom profile is strongly consistent with fibroids that may be affecting fertility. Please seek evaluation urgently — particularly if you are actively trying to conceive or have experienced pregnancy loss.
"Fibroids are one of the most common reasons I see women who have been trying for a baby for 2–3 years without understanding why it's not working. And when we find a submucosal fibroid on hysteroscopy — something a simple procedure can fix — and we do the hysteroscopy, and then the IVF works — that is one of the most gratifying things in this work. Don't let a fibroid quietly cost you years. Find out. Then decide."
— Dr. Richika Sahay Shukla, Chief Consultant & Director, India IVF Fertility
Fibroids are almost always benign (non-cancerous). The risk of a fibroid being malignant (leiomyosarcoma) is extremely rare — less than 1 in 1000. Their significance is functional: what they do to your bleeding, your quality of life, and your fertility — not cancer risk.
Fibroids rarely regress spontaneously during the reproductive years. After menopause, when estrogen levels drop, fibroids typically shrink significantly. GnRH analogue medications can temporarily shrink fibroids before surgery, but growth usually returns on stopping medication.
No. Only fibroids that distort the uterine cavity (submucosal, or large intramural fibroids impinging on the cavity) have well-documented negative effects on IVF outcomes. Small intramural fibroids not affecting the cavity may not require treatment before IVF. Our team will assess your scan carefully to advise.
Fibroids can recur after myomectomy, particularly in younger women with multiple fibroids. The recurrence rate is approximately 20–30% within 5 years. However, removing fibroids that are impairing fertility or causing significant symptoms is worthwhile, even with recurrence risk.
Not necessarily. A bulky uterus can indicate fibroids, adenomyosis, or simply a larger-than-average uterus within normal range. A detailed transvaginal ultrasound — and in some cases an MRI — is needed to differentiate between these causes and determine their significance.
This depends on the type of myomectomy and the depth of uterine wall involvement. For hysteroscopic myomectomy: typically 1–2 months. For laparoscopic myomectomy: 3–6 months, to allow the uterine wall to heal fully before the stress of pregnancy. Your surgeon will advise based on the specifics of your procedure.
Yes — particularly submucosal fibroids. They are associated with both implantation failure and early miscarriage. Removal of submucosal fibroids in women with recurrent miscarriage has been shown to significantly improve live birth rates in multiple studies.
Do the quiz above, get your risk result, and consult India IVF for confirmation with targeted tests and treatment planning.
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