Uterine fibroids, common non-cancerous growths in the uterus, can cause a range of symptoms, including heavy bleeding, pelvic pain, and, for some, fertility concerns. Uterine Fibroid Embolization (UFE) is a minimally invasive option for treating these fibroids. This procedure aims to alleviate symptoms by reducing fibroid size. This article explores UFE’s relationship with fertility, examining how it works and its potential effects on conception and pregnancy.
Understanding Uterine Fibroid Embolization
Uterine Fibroid Embolization shrinks fibroids by cutting off their blood supply. An interventional radiologist makes a small incision, typically in the groin or wrist, to insert a catheter into an artery. Using X-ray guidance, the catheter reaches the uterine arteries supplying blood to the fibroids, where microscopic particles are injected. These particles block blood flow, causing fibroids to shrink and die, alleviating symptoms like heavy bleeding and pelvic pain. This non-surgical approach preserves the uterus, offering an alternative to more invasive procedures.
How UFE Influences Fertility
The impact of UFE on fertility is a significant consideration, with research indicating both potential benefits and risks. By shrinking fibroids, UFE can resolve symptoms that hindered conception or led to pregnancy complications. Some studies suggest UFE can restore fertility, with reported pregnancy rates post-UFE ranging from 30-48%. One study found 41.5% of women unable to conceive before UFE became pregnant afterward.
However, the procedure carries some potential, though rare, risks that could theoretically impact fertility, such as ovarian impairment, particularly in women over 40. Concerns also exist regarding effects on the endometrial lining or uterine blood supply. Despite these, many pregnancies after UFE proceed uneventfully, demonstrating that conception and successful delivery are attainable. Discussing individual circumstances and fertility goals with a healthcare provider is important before undergoing the procedure.
UFE Versus Other Fibroid Treatments
When considering fibroid treatment, individuals often weigh UFE against myomectomy and, less commonly for fertility preservation, hysterectomy. Myomectomy, the surgical removal of fibroids while preserving the uterus, has historically been recommended for women desiring future pregnancies. This procedure can be performed through various approaches, depending on fibroid size and location. While myomectomy shows fertility rates around 53.6–55.9%, it is more invasive with longer recovery.
UFE is less invasive, with quicker recovery and no surgical incision. For numerous fibroids, UFE is advantageous as it treats all fibroids simultaneously. While earlier studies suggested higher rates of certain pregnancy complications after UFE, newer research indicates successful pregnancy outcomes are possible, with some studies showing comparable fertility rates. Hysterectomy, the complete removal of the uterus, eliminates future pregnancy and is reserved for cases where fertility preservation is not a consideration or other treatments failed.
Planning for Pregnancy After UFE
For individuals planning to conceive after UFE, specific considerations can help optimize outcomes. Healthcare providers recommend a waiting period, often three to six months, to allow the uterus to heal and fibroids to shrink, stabilizing the uterine environment and potentially improving conditions for a successful pregnancy. Close collaboration with an obstetrician or high-risk pregnancy specialist is important for monitoring. While some studies note a potential, albeit rare, increased risk of certain pregnancy complications, other research indicates complication rates are not significantly different from healthy women without fibroids. Many individuals successfully carry pregnancies to term and deliver healthy babies following UFE.