The Truth About Fertility and Pregnancy for woman over 30
- Dr. Ededet Udo
- Sep 19
- 3 min read
Pregnancy in Your 30s and beyond often comes with questions—and sometimes, unexpected concerns. One of the most common worries women hear about is the impact of growths in the uterus on fertility, pregnancy, and delivery. For years, the conventional wisdom has been that these growths always complicate pregnancy and must be removed before trying to conceive.
But is that really true?
Overview
We explore what the latest research actually shows about pregnancy for women over 30. You’ll learn:
How these growths affect pregnancy outcomes.
Whether surgery before pregnancy makes a difference.
What risks truly matter—and which ones may be overstated.
By the end, you’ll have a clearer understanding of what science says, and reassurance that successful, healthy pregnancies are possible—even when concerns like this are part of the conversation.
Practically all OB/GYN generalists have treated symptomatic fibroids and, on occasion, non-symptomatic fibroids. Managing symptomatic fibroids is usually straightforward.
The typical fibroid patient is older, often overweight, more likely to be of African descent, and may also have other health conditions such as high blood pressure or diabetes. She may also struggle with infertility.
Occasionally, a non-symptomatic fibroid is referred for treatment. For example, a woman may be referred for fibroid removal before pregnancy if it is believed that fibroids could affect her chances of conceiving, or cause complications during pregnancy, delivery, or postpartum recovery.
This discussion focuses on fibroids, pregnancy, and the need—or lack of need—for myomectomy (fibroid removal).
The long-standing consensus has been that fibroids grow during pregnancy and cause many complications. Still, many obstetrician-gynecologists have cared for women with fibroids who carried their pregnancies to term and delivered successfully without complications.
Recent research comparing pregnancy outcomes in women who had a myomectomy before pregnancy and women who did not shows no significant differences between the two groups. This means that insisting on a myomectomy should not automatically be considered a prerequisite for planning or attempting pregnancy.
What the Studies Show
Early pregnancy: There is no difference in miscarriage rates between women with fibroids who did not have a myomectomy and women who did. The location, size, and number of fibroids also do not appear to make a difference.
Late pregnancy and delivery: Fibroids may grow during the first trimester, but this growth typically slows in the second trimester and often decreases in the third trimester and after delivery.
Placental abruption: The highest risk occurs when the placenta is located behind a fibroid, but this is not always the case.
Preterm delivery: Fibroids are consistently linked with a higher risk of preterm delivery. However, research shows that removing fibroids before pregnancy does not reduce this risk—and may actually increase it.
Cesarean delivery: Both women with fibroids and women who have had a myomectomy are more likely to deliver by cesarean section.
Postpartum hemorrhage: Older women are at higher risk for postpartum hemorrhage, and because fibroids are more common in older patients, the two often appear together.
Conclusion
For women in their 30s and beyond who are considering pregnancy, the presence of fibroids is not automatically a barrier to a healthy outcome. While fibroids can increase certain risks—such as preterm delivery—they do not necessarily prevent conception, safe delivery, or a positive postpartum recovery. Most importantly, the latest research shows that surgery to remove fibroids before pregnancy does not guarantee better results and is not always necessary.
The bottom line: Every woman’s journey is unique, and decisions about treatment should be guided by careful discussion with a trusted healthcare provider—not fear or outdated assumptions.
