Uterine fibroids are benign growths made up of muscle and connective tissue that develop in or around the uterine wall. They are relatively common among women and may cause various symptoms, including heavy menstrual bleeding, pelvic pain, and fertility problems. Although not all fibroids are harmful, their type and location can affect a woman’s reproductive health.
For women who are planning a pregnancy or are already pregnant, the presence of fibroids may require special attention because certain types can interfere with conception and fetal development. One type particularly associated with fertility problems and an increased risk of miscarriage is the submucosal fibroid.
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Submucosal fibroids: The least common type, but the most likely to affect fertility
Submucosal fibroids are the least common type of uterine fibroid. However, compared with other types, they are the most likely to interfere with female fertility.
Submucosal fibroids grow just beneath the endometrium, the innermost lining of the uterus. Their growth can alter the shape of the uterine cavity, potentially increasing the risk of implantation failure. This occurs when a fertilized embryo fails to attach successfully to the uterine wall.
In addition to making it more difficult to become pregnant, submucosal fibroids have also been associated with an increased risk of miscarriage, potentially reaching 60% or more. This type of fibroid has also been linked to recurrent miscarriage, a condition in which a woman experiences three or more consecutive pregnancy losses.
For this reason, doctors often recommend removing submucosal fibroids before a woman tries to conceive, particularly if she is planning to undergo in vitro fertilization (IVF) or other fertility treatments.
Does having fibroids during pregnancy make it a high-risk pregnancy?
Having uterine fibroids does not automatically mean that a pregnancy is classified as high-risk. The risk of complications depends on the type, size, and location of the fibroids, as well as the symptoms experienced by the expectant mother. Not all fibroids need to be removed before pregnancy, as some do not interfere with pregnancy or fetal development.
Submucosal fibroids are the type most strongly associated with an increased risk of pregnancy complications. Their presence may make conception and maintaining a pregnancy more difficult, while also increasing the risk of preterm delivery. Some potential complications include:
- Restricted fetal growth: Very large fibroids may occupy a significant amount of space inside the uterus, potentially limiting the room available for the fetus to grow.
- Preterm labor: Fibroids that take up too much space in the uterus may trigger contractions before 37 weeks of pregnancy, increasing the risk of premature birth.
- Abnormal fetal position: Fibroids may affect the position of the fetus inside the uterus, potentially causing a breech presentation. In some cases, this may make a cesarean section necessary.
In addition to submucosal fibroids, large intramural fibroids, which grow within the muscular wall of the uterus, may also cause similar complications. However, these complications are relatively uncommon.
What symptoms of fibroids should you watch for during pregnancy?
Not all women with fibroids experience symptoms during pregnancy. However, some expectant mothers may experience several complaints, including:
- Abdominal pain or discomfort.
- A feeling of pressure or fullness in the pelvic area.
- Constipation or difficulty passing stools.
- More frequent urination.
- Lower back pain.
- Vaginal spotting or light bleeding.
In certain cases, fibroids may also undergo red degeneration. This occurs when changes develop within the fibroid tissue due to an insufficient blood supply, causing some of the tissue to become damaged. Red degeneration can cause significant abdominal pain.
In addition to pain, this condition may sometimes be accompanied by abdominal swelling, nausea, vomiting, fever, and an increased heart rate. If you experience these symptoms during pregnancy, seek medical attention promptly so that the cause can be identified and appropriate treatment provided, with consideration for both maternal and fetal safety.
Fibroid treatment at Mandaya Royal Puri Hospital with HIFU: Non-surgical technology without incisions
High-Intensity Focused Ultrasound (HIFU) is a non-invasive medical procedure that uses focused, high-intensity ultrasound waves to treat targeted tissue, including uterine fibroids and other benign tumors of the uterus.
Unlike conventional ultrasound, which is used to produce images of internal organs, HIFU uses ultrasound energy to generate heat within the targeted tissue. This thermal energy damages fibroid tissue without requiring surgical incisions.
The process can be compared to using a magnifying glass to concentrate sunlight onto a single point. During HIFU treatment, ultrasound waves are directed and focused on the fibroid tissue to generate high temperatures that damage the targeted cells.
In general, the HIFU procedure for treating uterine fibroids involves several steps:
- Identifying the fibroid location. The doctor examines the position and characteristics of the fibroid to determine the target area for treatment.
- Directing ultrasound energy. High-intensity ultrasound waves are directed toward the identified fibroid tissue.
- Focusing energy on the target tissue. The ultrasound energy is concentrated at a specific point, generating heat within the fibroid tissue.
- Damaging the fibroid tissue. The increased temperature causes ablation, or tissue damage, within the fibroid. Following treatment, the targeted tissue may gradually shrink.
One of the main advantages of HIFU is that it does not require incisions in the skin or uterus. Ultrasound energy passes through body tissues and is focused on the fibroid, helping minimize heat exposure to the surrounding healthy tissue.
During the procedure, doctors use imaging guidance to identify the fibroid’s location and monitor the ablation process. The imaging method may involve ultrasound or MRI, depending on the technology and treatment protocol available.
What are the advantages of HIFU for treating uterine fibroids?
HIFU may be an option for patients with uterine fibroids who meet the appropriate medical criteria. This technology allows doctors to target fibroid tissue using focused ultrasound energy without requiring open surgery or surgical incisions.
Some of the advantages of HIFU for treating uterine fibroids include:
1. No surgical incisions required
HIFU is a non-invasive procedure, meaning it does not require incisions in the abdomen or uterus to reach the fibroid tissue. The procedure also does not use radiation.
2. Precisely targets fibroid tissue
Ultrasound energy is focused on the fibroid tissue being treated. This approach helps minimize the effects of heat on the surrounding healthy tissue.
3. Relatively shorter recovery time
HIFU can generally be performed without hospitalization, potentially allowing patients to recover more quickly than they would after certain types of surgery. However, recovery time may vary from one patient to another.
Despite these advantages, HIFU is not necessarily suitable for every patient. Before recommending the procedure, doctors need to consider the size, number, and location of the fibroids, as well as the patient’s overall health and future pregnancy plans.
Profile and practice schedule of dr. Edward Tony Ngantung, Sp.OG, FESICOG, an obstetrician and gynecologist at Mandaya Royal Puri Hospital
dr. Edward Tony Ngantung, Sp.OG, FESICOG is an obstetrician and gynecologist with experience in managing various women’s reproductive health conditions. His services include pre-pregnancy consultations, pregnancy care, vaginal and cesarean deliveries, and the management of various gynecological conditions. He is also one of the obstetricians and gynecologists at Mandaya Royal Puri Hospital certified in HIFU for uterine fibroid treatment.
In addition to managing various pregnancy-related conditions, dr. Edward also has experience caring for pregnant patients with large uterine fibroids. This experience supports his approach to managing pregnancies complicated by fibroids, while taking the mother’s condition and fetal development into consideration.
dr. Edward has also been entrusted by several public figures, celebrities, and national athletes to accompany them during childbirth. These include national badminton player Anthony Sinisuka Ginting and Mitzi Abigail, badminton player Jonatan Christie and Shanju, as well as content creators Nex Carlos and Vienesca Laurencia. They chose dr. Edward to accompany them throughout their childbirth experiences at Mandaya Royal Puri Hospital.
dr. Edward Tony Ngantung, Sp.OG, FESICOG is available for consultations at Mandaya Royal Puri Hospital on the following schedule:
- Monday: 2:00 PM–4:30 PM
- Tuesday: 11:00 AM–2:00 PM
- Wednesday: 5:00 PM–8:00 PM
- Thursday: 5:00 PM–8:00 PM
- Friday: 10:00 AM–2:00 PM
- Saturday: 9:00 AM–1:00 PM
Facilities for out-of-town and international patients at Mandaya Royal Puri Hospital
Mandaya Royal Hospital Puri provides various supporting facilities to help patients traveling from other cities or countries feel more comfortable during their treatment:
- VIP transportation: A comfortable pick-up and drop-off service from Soekarno-Hatta International Airport, train stations, or seaports to the hospital, accompanied by a Patient Experience Officer (PEO).
- Medical ambulance transportation: A dedicated service for patients with specific medical needs, providing transportation from their arrival point (airport, train station, or seaport) in an ambulance equipped with medical facilities and accompanied by professional healthcare personnel.
- Accommodation (Sleep Hub and apartments): Comfortable accommodation for patients’ accompanying family members. Sleep Hub is located on the 8th floor of the Mandaya Royal Puri building, with nearby apartments also available.
- International Patient Relations: Dedicated assistance for international patients, including medical coordination, interpreter services, and administrative support. For further information and assistance, contact 021 5092 8888 or email [email protected].
To make your visit to Mandaya Royal Hospital Puri easier, you can use the WhatsApp chat feature, Book Appointment service, or the Care Dokter application, available for download on Google Play and the App Store. These services allow you to make appointments, check queue numbers, and access other useful information.
The information provided on this page is intended for educational purposes and as a general overview. It may not cover every type of medical service that each doctor is able to provide. To determine the most appropriate treatment for your health condition, we recommend consulting directly with the relevant doctor.
If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.
References:
- Cleveland Clinic. Uterine Fibroids. (https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids). Accessed November 12, 2026.
- Cleveland Clinic. Can Fibroids Affect Your Chances of Getting Pregnant or Having a Healthy Pregnancy? (https://health.clevelandclinic.org/can-fibroids-affect-your-chances-of-getting-pregnant-or-having-a-healthy-pregnancy). Accessed November 12, 2026.
- Cleveland Clinic. HIFU (High-Intensity Focused Ultrasound). (https://my.clevelandclinic.org/health/treatments/16541-hifu-high-intensity-focused-ultrasound). Accessed November 12, 2026.