Uterine fibroids, and in particular those which distort uterine anatomy and interfere with normal uterine physiology, can have adverse effect on reproductive function, leading to sub-fertility, later pregnancy complications, and miscarriage16. The incidence of fibroids in infertile women without any other obvious cause of infertility is estimated to be between 1% and 2.4%, however, there is a lack of prospective studies available to clearly determine the burden of fibroids in terms of their impact on fertility17.
A number of factors may influence fertility and pregnancy outcomes, including the size, location, and number of fibroids. Available evidence suggests that submucosal, intramural, and subserosal fibroids interfere with fertility in decreasing order of importance. Indeed, submucosal fibroids are linked to a 70% reduction in delivery rate17. There is some data suggesting an impact of the number and dimension of the lesions on fertility; in particular, fibroids over 5 cm in diameter, and located close to the cervix, are more likely to pose a problem16.