Uterine fibroids are common, noncancerous growths that develop in the uterus, affecting many women during their reproductive years. These fibroids can cause various symptoms, including heavy bleeding and pelvic pain. Uterine Fibroid Embolization (UFE) is a widely available treatment option for managing these symptoms. A frequent concern for women considering this procedure is whether UFE impacts their ability to conceive and carry a pregnancy to term. This article explores current research to address the question of UFE’s relationship with fertility.
Understanding Uterine Fibroid Embolization
Uterine Fibroid Embolization (UFE) is a minimally invasive procedure. It involves blocking the blood supply to the fibroids, causing them to shrink and symptoms to improve. An interventional radiologist typically performs UFE by making a small puncture, often in the groin area, to access a blood vessel. Through this tiny opening, a thin, flexible tube called a catheter is guided to the arteries that supply blood to the fibroids. Very small particles, similar in size to grains of sand, are then injected into these arteries, blocking the blood flow and effectively starving the fibroids. The goal of the procedure is to alleviate fibroid-related symptoms such as heavy menstrual bleeding and pelvic pain.
UFE and Fertility: What the Research Indicates
Research indicates that UFE generally does not prevent women from conceiving. Studies suggest that UFE is considered a fertility-sparing option, particularly when compared to more invasive surgical procedures like hysterectomy, which involves removing the uterus entirely. The ability to conceive following UFE varies among individuals, but overall pregnancy rates are encouraging. Some studies report pregnancy rates ranging from 30% to 48% after UFE.
For instance, one study found that approximately 40% of patients became pregnant within two years of UFE, with a significant number achieving live births. Another review indicated an overall pregnancy rate of 58.6% for women who had UFE. While earlier concerns existed about UFE potentially affecting ovarian function, more recent evidence suggests that the risk of ovarian impairment is minimal, especially in women under 40. This indicates that for many women, UFE allows them to manage fibroid symptoms while preserving their reproductive potential. It is important for individuals to discuss their specific circumstances and fertility goals with a healthcare provider to determine the most suitable treatment path.
Pregnancy Outcomes Following UFE
While UFE generally supports the ability to conceive, potential outcomes during pregnancy should be considered. Some studies have suggested a possible increase in certain pregnancy complications for women who have undergone UFE. These considerations include a potential for higher rates of miscarriage, preterm birth, and placental abnormalities. For example, one review indicated a miscarriage rate of 28% after UFE, which was similar to women with fibroids who did not undergo the procedure.
However, it is also widely reported that many women experience healthy pregnancies and successful deliveries after UFE. The presence and characteristics of fibroids themselves can influence pregnancy outcomes, regardless of the treatment method. Some research suggests that any increased risk might be related to the complexity of the fibroids rather than the UFE procedure itself, and that modern UFE techniques may lead to improved outcomes. While some studies note a higher likelihood of cesarean sections, other obstetric risks may not be elevated when age and patient demographics are considered.
Fibroid Treatment Options for Fertility Preservation
For women prioritizing fertility preservation while treating uterine fibroids, several options are available. Myomectomy, a surgical procedure that involves removing the fibroids while leaving the uterus intact, is often considered a primary treatment for those wishing to conceive.
Beyond myomectomy and UFE, other fertility-sparing treatments exist. Magnetic Resonance-guided Focused Ultrasound Surgery (FUS) uses high-frequency sound waves to destroy fibroid tissue without incisions, preserving the uterus. Radiofrequency ablation is another minimally invasive option that uses heat energy to shrink fibroids. The choice among these treatments depends on various factors, including the size, number, and location of the fibroids, as well as individual health and fertility goals.