Uterine fibroids (also called leiomyomas) are one of the most common benign growths found in women of reproductive age. They affect 10–20% of women in their twenties and thirties, and this number increases to 40–50% in later years.

At Janini IVF, Delhi NCR, we frequently see fibroids in women facing infertility, and it is well established that women with fibroids may have more difficulty conceiving than those without them. Understanding the type, size, and location of the fibroid is essential to choosing the right fertility plan.

What Are Uterine Fibroids?

Fibroids are non-cancerous growths of the smooth muscle of the uterus. While they are common and often harmless, they can sometimes affect menstrual health, pregnancy, and fertility — especially when they distort the cavity of the uterus.

Risk Factors for Developing Fibroids

As shared by the specialists at Janini IVF, factors that may increase the likelihood of fibroids include:

• Late marriages or delaying pregnancy into the thirties

• Not breastfeeding after childbirth

• Exposure to environmental toxins (like dioxins), certain medicines, or excessive estrogen exposure

• Genetic or hereditary predisposition

• No clear cause — many fibroids develop without any identifiable reason

Types of Uterine Fibroids and Their Symptoms

Symptoms depend on where the fibroid is located, its size, and how many are present. Fibroids are broadly divided into three categories:

1. Subserosal Fibroids (Outer Wall)

• Located on the outer surface of the uterus

• Usually cause no symptoms

• If pedunculated (attached by a thin stalk), they may twist and cause intense sudden pain

• Can occasionally “wander” in the abdomen causing infertility or intestinal obstruction

2. Intramural Fibroids (Within the Wall)

• Found inside the uterine wall

• Often considered the most harmless type

• Large intramural fibroids (5–8+ cm) may cause:

• Cramps

• Heavy bleeding (menorrhagia)

• Pressure symptoms like constipation or urinary difficulty

3. Submucosal Fibroids (Inside the Cavity)

These are the most important fibroids in terms of fertility.
They can cause:

• Irregular bleeding

• Heavy periods

• Infertility due to disrupted implantation

• Higher miscarriage rates, even when conception occurs

Complications Caused by Fibroids

Fibroids may lead to:

• Menorrhagia ? fatigue, weakness, anaemia

• Painful periods (dysmenorrhea)

• Abdominal discomfort, bowel or bladder pressure

• Problems in pregnancy such as miscarriage, preterm labour, or obstructed labour

• Rarely, cancerous change (leiomyosarcoma — extremely rare)

• Infertility — especially with submucosal fibroids near the endometrial lining

How Fibroids Are Diagnosed at Janini IVF

At Janini IVF, Delhi, diagnosis always begins with a detailed medical history and review of all previous test reports. Additional evaluations include:

Ultrasound Scan

The primary and essential tool to map fibroids — number, size, location, and relevance to infertility.

Laparoscopy

A minimally invasive procedure that allows direct visualisation of fibroids and the pelvic organs. Fibroids can also be removed during the same procedure.

Hysteroscopy

Used when the fibroid has a submucosal component or lies inside the uterine cavity.
Allows direct assessment and removal using a resectoscope.

Treatment of Uterine Fibroids at Janini IVF

Fibroid management is always individualised, based on:

• Your age

• Duration of infertility

• Symptoms

• Husband’s semen parameters

• Size, type, and site of fibroids

• Your preference for medical vs. operative treatment

• Disease progression

• Whether fertility is urgently needed

Importantly, not all fibroids need treatment, especially small subserosal or intramural fibroids that do not impact fertility.

When treatment is necessary, options include:

1. Laparoscopic Myomectomy

The preferred modern surgery for fibroid removal.
Minimally invasive, faster recovery, and safe in expert hands.

2. Hysteroscopic Myomectomy

Best for fibroids within or pressing into the uterine cavity.
Performed using a resectoscope by an experienced surgeon like Dr. Dalal, who has performed thousands of such procedures.

3. Combined Laparo-Hysteroscopy

Used when fibroids are located in multiple positions, allowing complete removal in one sitting.

4. MRgFUS (MRI-Guided Focused Ultrasound)

Uses heat waves to shrink fibroids.
Promising but still evolving; not yet proven long-term.

5. Laser Ablation

Coagulates fibroid tissue but is expensive and less preferred.

6. Uterine Artery Embolisation (UAE)

Minimally invasive but not preferred for women who want to conceive, as its effect on future pregnancies is unclear.

7. Medical Management

Medications such as aromatase inhibitors, SPRMs, mifepristone, NSAIDs, GnRH agonists —
Not suitable for most women seeking fertility treatment.

8. No Treatment (When Appropriate)

For harmless fibroids that do not affect fertility, proceeding directly to IVF may be the best plan.

Why Choose Janini IVF for Fibroid-Related Infertility?

At Janini IVF, the goal is not just to treat fibroids — but to treat you.

• Detailed review of reports

• Transparent, evidence-based advice

• Only necessary procedures

• Individualised plans based on your fertility goals

• A team led by Dr. Rutvij Dalal and Dr. Akanksha Mishra, offering scientific excellence and compassionate care

At Janini IVF, we treat the patient, not the ultrasound report!

Take the Next Step with Janini IVF