Experiences of women desiring pregnancy following uterine fibroid diagnosis

OBJECTIVE: To investigate rationale for treatment decisions regarding reproductive planning, implications of those treatment decisions, and reproductive outcomes following uterine fibroid diagnosis. STUDY DESIGN: Qualita­tive research methods were used to develop a semi-structured interview guide. Telephone interviews were conducted with women of reproductive age (18–45 years) with a uterine fibroid diagnosis. Iterative themes were identified following analysis of interviews using principles of grounded theory. RESULTS: Of the 47 women who completed an inter­view, 40 expressed a desire for future pregnancy or had attempted to conceive following a uterine fibroid diagnosis, including 6 who had experienced or intended to undergo an assisted reproduction procedure. Many participants believed that provider discussions  about the impact of uterine fibroids on fertility were intended to rule out fertility-sparing treatment options instead of supporting their reproductive goals. Reproductive outcomes varied, including live births, miscarriage, complicated pregnan­cies, and failure to conceive. Participants attributed neg­ative outcomes to uterine fibroids even when unconfirmed by a medical provider and reported relational, financial, and emotional impacts of navigating reproduction following uterine fibroid diagnosis. CONCLUSION: Findings suggest that fertility options, including assisted reproduction, should be proactively discussed early in the diagnosis and treatment process.