Fibroid and infertility

Written by Oladapo Ashiru

~Punch Nigeria. Wednesday, August 22, 2018.

Oladapo Ashiru

In general, it is a well-known medical fact that most women will have fibroids during their lifetime. Fibroids affect around 30 per cent of all women by the age of 35 years, and from 20 to 80 percent by 50 years. They usually develop between the ages of 16 and 50 years.

The estrogen levels are higher at this reproductive period. In the past, women of this age would have already completed a family. But, today, many women have children later in life. It is common to start a family in your thirties or even forties, rather than in your twenties. It makes understanding the potential relationship between fibroids and infertility very important.

Several authors confirmed that many women will have fibroids that would not hurt their chances of having children. The fibroids may stay small, or occur in areas that don't affect the reproductive system. But certain fibroids will have a profound effect on the ability to conceive, stay pregnant and carry a baby to term.

Based on their anatomical locations in the body, fibroids may prevent sperm and egg from meeting for conception. Fibroids can hamper the ability of an embryo to implant. They often grow in places or to sizes that make it challenging for a pregnancy to continue. Fibroids may even affect the health and welfare of the fetus.

Fibroids can reduce your fertility in these ways:

• Fibroids that change the shape of your cervix can affect the number of sperm able to enter the uterus.
• Fibroids that block the Fallopian tubes can make the journey of a fertilised egg to implantation difficult or impossible.
• Fibroids which change the shape of your uterus may decrease the number of places an embryo can successfully implant or reduce uterine space needed for embryo development.
• Fibroids that weaken the lining of the uterine cavity or decrease the blood supply to a growing embryo can cause miscarriage.

Prevalence

Estimating the overall incidence of fibroids in the population depends on the community under investigation and the sensitivity and specificity of the methods used to detect fibroids.

In a study by Oguniyi and Fasuba 1990; Sankaran and Manyonda, 2008), ultrasonography estimated a prevalence of 6.83% in asymptomatic Nigerian women.

This value is close to what has been reported in other parts of South-West Nigeria: 7.6 per cent and 8.35 per cent were recorded for Ife and Ilesha, both in Osun state, respectively; 3.2 per cent for Sagamu, Ogun State (Akinyemi et al., 2004).

However, higher values have been reported for other parts of the country, especially the eastern part: 13.6 per cent was recorded in Ebonyi State (Obuna et al., 2008); 19.75 per cent was reported for Irrua, Edo State; 25.9% obtained in Enugu (Ozumba et al., 2011).

What causes fibroid?

A review of the causes of fibroid points to the following as possible causes:

1. Having less than two children

It appears that the more children you have, the less likely you are to develop fibroids. It's not clear to researchers just why this is, and it is important to note this does not mean women should have more children to avoid fibroids, since fibroids occur even in women with three or four children

2. Drinking alcohol

The Black Women's Health Study noted that in black women consuming alcohol, particularly beer, there is an association between the developments of uterine fibroids. Consider reducing your intake of alcohol, especially beer to once per week or less.

3. Not eating enough fruit

We all know we should eat a variety of fruits and vegetables every day. In a study of dietary habits, researchers found that two servings of fruit a day, especially citrus fruits, was associated with a lowered risk of uterine fibroids.

If you are not consistent with eating fruits and vegetables frequently, perhaps just knowing you might be lessening your chance of developing fibroids will help you want to eat them more regularly. Please note that the fruits are better if they are the one that grows in your genetic environment and must be in moderation. Hence apple and overseas grapes are out!

4. Starting menstruation early

Fibroids are sensitive to hormones, particularly estrogen. It may explain the fact that women who begin menstruating before the age of 11 are more likely to develop fibroids compared to women who start menstruating after the age of 13. Of course, there is little you can do to change the period at which you started menstruating.

5. Vitamin D deficiency

Vitamin D is a fat-soluble vitamin that is present in certain foods, particularly dairy. The exposure of our skin to sunlight enables our bodies to produce vitamin D. Research has shown that vitamin D can diminish the growth of cells and regulate the immune system. Vitamin D also limits the production of fibrous tissue by fibroid cells. It is essential to make sure you're getting an adequate amount of vitamin D.