If you think of an embryo as a baby, the uterine cavity is the room in which the baby lives. Embryos are very “picky” and must be warm, comfortable and the right size to live in. Therefore, before the embryo is implanted, the doctor will carefully check if your “room” is ready. Not only should the inside of the room be clean, but also the walls (i.e., the myometrium) should not be overly large in the middle, affecting the shape and design of the room, and there should be no water outside the room (e.g., fluid in the fallopian tubes). Uterine fibroids are masses that occur in the uterus and are common benign tumors in women of childbearing age. Infertility due to fibroids alone accounts for about 3% of cases. The impact of different types of fibroids on fertility varies. The presence of a fibroid is like a stone, the one in the “room” (i.e. submucosal fibroids) must be removed before embryo transfer, the stone between the walls (i.e. interstitial fibroids) does not usually affect the design of the room, but a stone between the walls that is too large can affect the size and shape of the room, and the stone outside the room (subplasma fibroids) does not affect the room. The stones outside the room (subplasmalemma) have no effect on the room and can be ignored for the time being. Professionally, subplasmic fibroids have no significant effect on conception and pregnancy outcome; interstitial fibroids growing in the myometrium, such as those >100 px in diameter, have been shown to decrease pregnancy rates and increase miscarriage rates. The impact of submucosal fibroids on embryonic implantation is unquestionable, as they alter the volume and shape of the uterine cavity. The location and size of fibroids are associated with infertility. If fibroids cause changes in the morphology of the cervical uterine cavity and fallopian tube opening, resulting in blockage of the uterine cavity and fallopian tubes, they directly affect the transport of sperm and fertilized eggs, which affects embryo implantation. Larger interstitial myomas can lead to normal alignment of uterine muscle fibers and alter the polarity of uterine contraction waves, thus affecting sperm transport and embryo implantation. In addition, the endometrium surrounding the myoma exhibits glandular hyperplasia and polyp formation, and its accompanying hyperestrogenic environment can interfere with conception. Most fibroids are easier to detect with associated sonographic changes on routine ancillary examinations such as ultrasound. Hysteroscopy is often ordered for suspected submucosal fibroids found during treatment to further confirm the intrauterine environment. If submucosal fibroids are found under hysteroscopy, further hysteroscopic electrosurgery will be required. For larger fibroids that are compressing the endometrium, laparoscopic or open myomectomy will be needed to treat the fibroids, otherwise it will affect the embryo fertility and increase the risk of miscarriage. After myomectomy, due to scar healing, it is usually necessary to rest for about 1 year before pregnancy can be arranged, otherwise there is a higher risk of uterine rupture. For fibroids that do not require surgical treatment and can be temporarily observed, the size of the fibroids can be monitored by annual ultrasound examinations, and if they increase rapidly in a short period of time, they will need to be seen as an outpatient. Short-term use of ovulation-promoting drugs generally has little effect on the growth of fibroids, and frequent ultrasound monitoring during ovulation-promoting procedures also reduces concerns about the growth of fibroids. As a result, the “stay” or “don’t stay” of myoma needs a comprehensive assessment by the doctor, and as the “head of the house”, it is recommended to listen to the advice carefully. As the “head of the house”, it is recommended to listen carefully to the advice and work together to clean the room and prepare for the joy of a new life, so that a good pregnancy can start from here.