Which fibroids affect fertility, and when is myomectomy recommended?

Submucosal fibroids (those that grow into the uterine cavity) and intramural fibroids that distort the cavity are the types most consistently linked with fertility challenges. They can interfere with implantation and are more often associated with miscarriage risk and pregnancy complications than fibroids that sit on the outside of the uterus.

Myomectomy is most often recommended when a fibroid is cavity-distorting, or when intramural fibroids are causing significant symptoms and may be affecting reproductive plans—especially if you’re trying to conceive or preparing for IVF/other fertility treatment. In contrast, subserosal or pedunculated fibroids (on the outer surface of the uterus) rarely impact fertility unless they’re very large or creating other problems. Our team can review your imaging, clarify whether the cavity is involved, and help you decide whether surgery is likely to improve your chances of a healthy pregnancy.