Uterine Fibroids (Leiomyomas)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Uterine fibroids, or leiomyomas, are benign smooth-muscle tumors of the uterus that are classified by their anatomic location, which directly determines their fertility impact.¹ They are among the most common findings in reproductive-age women and range from clinically insignificant to a primary driver of implantation failure and pregnancy loss depending on their size, number, and relationship to the uterine cavity.

Location is the critical variable. Submucosal fibroids project into the uterine cavity and carry the highest fertility burden: they alter endometrial blood flow, distort the implantation surface, and impair embryo retention.¹ Intramural fibroids occupy the muscular wall and affect fertility when they are large enough to distort the cavity or compress the interstitial tubal segment. Subserosal fibroids project outward from the uterine surface and have the least direct impact on implantation, though large subserosal masses can impair tubal mobility or contribute to pelvic pain.

Fertility-preserving surgical removal, myomectomy, is the standard restorative intervention when fibroids are contributing to reproductive dysfunction. Route depends on location: submucosal fibroids accessible to the cavity are addressed via operative hysteroscopy; intramural or subserosal fibroids require operative laparoscopy or mini-laparotomy based on size and depth. The goal is to restore normal uterine architecture before attributing infertility or pregnancy loss to other causes.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.