Introduction
Heavy periods, pelvic pain, bloating, unexplained trouble conceiving — all unsettling when you don't know the cause. Two of the usual suspects are fibroids and polyps, and the good news is both are generally straightforward to identify and manage once properly diagnosed. Here's what they are, how they differ, and how a detailed ultrasound can give you real answers.
What Are Fibroids?
Fibroids are non-cancerous growths in or around the womb. They're common, especially in women in their 30s and 40s, and range from pea-sized to, in rare cases, as large as a melon. Plenty of women have them without ever knowing. For others, fibroids bring heavy or prolonged periods, pelvic pain or pressure, bloating, frequent urination, and sometimes difficulty conceiving or pregnancy complications.
What Are Polyps?
Polyps are also non-cancerous, but they grow in the lining of the womb (endometrial polyps) or sometimes the cervix. They're usually smaller than fibroids and often linked to oestrogen fluctuations. Watch for irregular bleeding between periods, spotting after menopause, heavier periods, and occasionally fertility difficulties if a polyp gets in the way of implantation.
What's the Difference Between Fibroids and Polyps?
Fibroids grow from the uterus's muscular wall; polyps grow from its lining. Fibroids tend to be firmer and can grow large; polyps are typically smaller and softer. Since the symptoms overlap so much, imaging is the only reliable way to tell them apart — and to rule out anything else.
How Are Fibroids and Polyps Diagnosed?
This is where ultrasound earns its keep. A detailed scan mapping the fibroids gives our specialists a level of clarity, pinpointing the exact size, number, and location of any fibroids or polyps. That detail matters most if you're dealing with fertility difficulties or recurrent miscarriage, since where a growth sits often determines whether — and how — it should be treated.
The scan itself is quick, painless, and non-invasive, with results usually discussed the same day.
Do Fibroids or Polyps Always Need Treatment?
Not always. Many are small, symptom-free, and simply monitored rather than treated. When treatment is needed, options range from medication through to minimally invasive removal, depending on size, location, and how it's affecting your life or fertility plans. There's no one-size-fits-all answer here — your specialist will talk you through what fits your situation.
Fibroids and Fertility: What Does the Latest Research Say?
One question we hear often: should a fibroid come out before starting IVF or ICSI? It's especially debated for intramural fibroids — those sitting within the muscular wall of the uterus.
Our specialist, Miss Neelam Potdar was the senior author for a systematic review and meta-analysis on exactly this, published in the International Journal of Gynecology & Obstetrics (2025). Drawing on seven studies and over 1,600 women, the research found that women who had a myomectomy for intramural fibroids before IVF had a notably higher chance of an ongoing pregnancy or live birth than those who didn't.
A caveat worth knowing: this is based on observational studies, not randomised trials, and the studies varied in how they classified fibroids — so treat it as encouraging evidence, not a guarantee. What it does support is an individualised approach, weighing the size, number, and position of your fibroids against your fertility plans.
If you have intramural fibroids and IVF or ICSI is on the horizon, a detailed mapping ultrasound scan can help clarify exactly what you're dealing with, alongside a specialist who knows both the imaging and the research.
Read the full published research: Myomectomy for intramural fibroids prior to in vitro fertilization/intracytoplasmic sperm injection cycles, a conundrum: Systematic review and meta-analysis, Verma S, Shanbhag A, Salim S, Potdar N. International Journal of Gynecology & Obstetrics, 2025.
When Should I Get Checked?
If you're dealing with heavy or irregular periods, pelvic pain or pressure, unexplained bleeding, or trouble conceiving, a detailed scan beats guessing every time. Knowing exactly what's going on is the first real step toward feeling like yourself again — and making informed decisions about treatment and your future.
Book your specialist ultrasound scan with Althea Women's Health today.
This article is for general informational purposes and does not replace personalised medical advice. Please speak with one of our specialists about your individual circumstances.