Note:
In the following abstracts form different research articles by prominent authors, you will see clearly how uterine artery embolization (UFE) not only preserves fertility, but also may restore fertility. We have many patients in our practice that have achieved pregnancy after UFE with successful deliveries.
①
Pisco JM, Duarte M, Bilhim T, Branco J, Cirurgião F, Forjaz M, Fernandes L, Pereira J, Costa N, Pisco JBM, Oliveira AG.
Spontaneous Pregnancy with a Live Birth after Conventional and Partial Uterine Fibroid Embolization.
Radiology. (2017)
Summary:
The purpose of this study was To determine pregnancy rates after conventional and partial uterine fibroid embolization (UFE).
The authors concluded:
Our findings show that UFE is a fertility-restoring procedure in women with uterine fibroids who wish to conceive, and pregnancy following UFE appears to be safe with low morbidity.”
“Women who had been unable to conceive had normal pregnancies after UFE and similar complication rates as the general population in spite of being in a high-risk group.”
“UFE may become the first-line treatment for women with fibroids who wish to conceive, particularly for those with numerous or very large fibroids. Such patients have a fibroid recurrence rate of more than 60 percent after myomectomy, making UFE an important option.”
“Since the time of writing, there were 12 additional pregnancies.”
“In our study there are now almost 200 newborns following UFE.”
②
Nigel Hacking, Ganesh Vigneswaran, Drew Maclean, Timothy Bryant, Sameer Umranikar, Ying Cheong & Sachin Modi:
The impact on Anti-Mullerian Hormone (AMH), uterine fibroid size and uterine artery patency following Uterine Fibroid Embolization (UFE) with a resorbable embolic agent,
Human Fertility (2022)
Summary:
This paper looked at the impact of fibroid embolization on the anti-mullerian hormone. A low level of anti-mullerian hormone is usually associated with a decline in reproductive capacity.
The authors concluded:
UFE with Gel-bead did not significantly affect AMH at 3 months post embolization, whilst maintaining a high rate of uterine artery patency.
③
Kim MD, Kim NK, Kim HJ, Lee MH.
Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis.
Cardiovasc Intervent Radiol. (2005).
Summary:
This study was done to determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.
The authors concluded:
Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure.
④
Ganapati H, Sanaati M, Shakiba M, Bakhshandeh H, Ghavami N, Aro S, Jalali AH, Firouznia K.
Pregnancy and its Outcomes in Patients After Uterine Fibroid Embolization: A Systematic Review and Meta-Analysis.
Cardiovasc Intervent Radiol. (2020)
Summary:
This study was done to assess fertility, pregnancy and its outcomes in patients who have undergone UAE.
The authors concluded:
Considering the findings of the study, a safe pregnancy after UAE is obviously possible resulting to a healthy and normal baby delivery. In addition, pooled obstetrical complication rates, pregnancy losses, preterm labor and LBW seem to be mostly similar to the general population.
⑤
Mailli L, Patel S, Das R, Chun JY, Renani S, Das S, Ratnam L.
Uterine artery embolization: fertility, adenomyosis and size – what is the evidence?
CVIR Endovasc. (2023)
Summary:
The study carried out a focused literature review on three particularly challenging aspects – post-procedure fertility, symptomatic adenomyosis and large volume fibroids and uteri, to enable operators to utilize evidence-based guidance in patient selection, consent, and management.
The authors concluded:
Our findings suggest uterine artery embolization can be offered to women desiring pregnancy with fertility and miscarriage rates comparable to that of the age-matched general population. It is also an effective therapeutic option for symptomatic adenomyosis as well as for the treatment of large fibroids > 10 cm in diameter.
⑥
Akhatova A, Aimagambetova G, Bapayeva G, Laganà AS, Chiantera V, Oppelt P, Sarria-Santamera A, Terzic M.
Reproductive and Obstetric Outcomes after UAE, HIFU, and TFA of Uterine Fibroids: Systematic Review and Meta-Analysis.
Int J Environ Res Public Health. (2023)
Summary:
This systematic review and meta-analysis aims to assess and compare reproductive and obstetric outcomes in women who underwent these minimally invasive approaches for uterine fibroids.
The authors concluded:
The available evidence confirmed that these minimally invasive uterine-sparing treatment options for uterine fibroids are a good approach for patients wishing to preserve their fertility, with comparable reproductive and obstetric outcomes among the different techniques.
