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Pregnancy following uterine fibroid embolization
Summary
Uterine fibroid embolization (UFE) allows for term pregnancies with low risks of infertility or complications. UFE is a viable option for women desiring future fertility, comparable to myomectomy.
Area of Science:
- Reproductive Medicine
- Interventional Radiology
- Gynecologic Surgery
Background:
- Uterine fibroids are common, potentially impacting fertility and pregnancy outcomes.
- Uterine fibroid embolization (UFE) is an alternative to surgical myomectomy for fibroid management.
- The impact of UFE on subsequent fertility and pregnancy is a critical consideration for reproductive-aged women.
Purpose of the Study:
- To evaluate the feasibility of achieving term pregnancies after UFE.
- To identify potential impediments to conception and pregnancy following UFE.
- To compare the safety and efficacy of UFE with myomectomy regarding fertility preservation.
Main Methods:
- A cohort of 400 women undergoing UFE was retrospectively analyzed.
- Fertility desires were assessed pre-embolization.
- Follicle-stimulating hormone levels, pregnancy attempts, menstrual history, and pregnancy outcomes were monitored post-embolization.
- Radiation exposure and complications were documented.
Main Results:
- Of 139 women desiring fertility, 17 pregnancies occurred in 14 women.
- Ten normal term deliveries and two ongoing pregnancies were reported.
- Complications included premature menopause in 4 women (<45 years) and hysterectomy in 2 women.
- Average radiation dose was 14 rads; no pregnancy or labor perfusion issues were noted.
Conclusions:
- UFE is associated with small risks of infertility, premature menopause, and hysterectomy, comparable to myomectomy.
- Fertility rates and pregnancy outcomes following UFE are favorable.
- UFE is a safe and effective treatment option for women with uterine fibroids who wish to preserve fertility.