The impact of uterine artery embolization on ovarian function

Soon after the introduction of uterine artery embolization (UAE) as a treatment for fibroid tumors, questions arose regarding its potential impact on ovarian function. The onset of amenorrhea caused by ovarian failure after UAE was reported, and occlusion of ovarian arterial supply via uterine-arterial communications was suspected as the mechanism. Despite that, premature induction of menopause after UAE remains very infrequent. Perhaps of greater concern is a subclinical diminution of ovarian functional reserve. Data from randomized trials and prospective case series suggest that degradation of ovarian function may occur after UAE, but is concentrated in women older than age 45 years, with little evidence of an impact in women younger than 40 years of age. This review is intended to summarize current knowledge regarding the impact of UAE on ovarian reserve and the induction of menopause.