Uterine fibroid embolization and pregnancy outcome

Hatami, M.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p10
Academic Journal
Introduction: Uterine fibroids are common in reproductive age. Around 10-20% of women who have fibroid require treatment and 1%-2% of infertility in women is due to fibroids. To determine and compare fibroid treatment effects on fertility, and to review the role of uterine fibroid embolization (UFE) in pregnancy outcome. Materials and Methods: A literature review was undertaken to include the published articles about UFE between 1995-2014. Results: Gn-RH agonists treat fibroids by blocking the estrogen and progesterone releasing, cause a postmenopausal situation and decrease the fibroid size. Usual surgical procedures contain hysterectomy and abdominal myomectomy. Minimally invasive procedures like laparoscopic or robotic myomectomy arc less invasive. Hysteroscopic myomectomy, endometrial ablation and sub mucosal fibroid resection are vaginally options. New non-invasive method, Magnetic Resonance Guided Focused Ultrasound is under research. UFE is a less invasive procedure, preserve uterus and requires a small incision into the femoral artery for using microspheres or polyvinyl alcohol particles to block the blood supply to the uterine fibroids, causing them to shrink. Numerous successful pregnancies after UFE have been reported. In Ravina's study, among 184 women who had UFE, 12 unexpected pregnancies occurred. McLucas reported that 22 of the 28 pregnancies after UFE were normal full term pregnancy. He compared the pregnancy rate of his cohort study after UFE (47.7%) to abdominal myomectomy where was in the range of 10-46%, laparoscopic myomectomy (16-33%), and hysteroscopic myomectomy (8-35%). Conclusion: UFE as an acceptable fibroid treatment should be considered in young women, as benefits, risks and further fertility evaluation is suggested.


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