Sometimes misdiagnosed, these conditions have different fertility implications

Uterine fibroids and adenomyosis are benign conditions involving abnormal tissue growth in the uterus. Where they occur affects their impact on someone’s health. Both adenomyosis and uterine fibroids can contribute to infertility.

With the right diagnosis and treatment, getting pregnant can be within reach for women who have either condition.

What is adenomyosis?

This occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus. This may cause painful, heavy periods. It is sometimes seen with other uterine conditions such as endometriosis, which is when endometrial tissue grows outside the uterus.

What are uterine fibroids?

Fibroids are also growths but they occur within the muscle walls of the uterus (womb) itself and are made up of muscle tissue. They can develop at any time, but typically form around a person’s childbearing years.

Symptoms of uterine fibroids and adenomyosis

Women with these conditions often feel pelvic pain, bloating or pressure, but other common symptoms include:

• Long-lasting, heavy periods.
• Painful intercourse.
• Infertility.

Since the symptoms are so similar, adenomyosis is sometimes misdiagnosed as uterine fibroids. They are distinct conditions, however. While fibroids are benign tumors growing in or on the uterine wall, adenomyosis is less of a defined mass of cells located within the uterine wall.

Can you still get pregnant?

If a person with a uterus is diagnosed with one of these conditions and wants to get pregnant, they might assume all hope is lost. Unfortunately, the common misconception that uterine issues and infertility always go hand-in-hand has caused untold amounts of stress.

Depending on their location and severity, overgrowths of tissue in the uterus from either condition can affect fertility.

With uterine fibroids, most women will get pregnant and deliver a healthy baby. However, in some cases, growths can block the sperm from reaching the egg, which certainly makes fertility difficult. They may also impact the cavity of the uterus and can contribute to difficulties with embryo implantation or even miscarriage. Treatment can range from medication to surgery, depending on the specific case.

Aside from their effect on infertility, another concern with having uterine fibroids is possible complications during labor and delivery. Those with fibroids are six times more likely to have a C-section.

With adenomyosis, research is much less clear. Since it is so often accompanied by endometriosis, the condition has emerged as an area of interest for further study. Preliminary research suggests that adenomyosis has a negative impact on female fertility. It also links the condition to lower success rates with in vitro fertilization (IVF) and higher miscarriages.

Much like fibroids, adenomyosis may also lead to labor and delivery complications. This too depends on the specifics and severity of the case.

While these findings do not preclude women with adenomyosis from getting pregnant and having a healthy delivery, they do warrant concern. A screening and potential diagnosis can guide doctors to appropriate treatment options.

Fertility options with fibroids or adenomyosis: what next?

For those experiencing symptoms, it is best to talk with a physician and, if looking to start a family, seek the guidance of a fertility specialist. A person’s reproductive goals is an important factor in determining the best treatment plan.

The spectrum of options depends on many factors, including the person’s diagnosis, age, reproductive history, overall health, and the results from an infertility evaluation.