Monday, February 21, 2005

Fibroid Embolization (UAE/UFE) for Women of Childbearing Age

(to a woman interested in learning more about whether or not it impairs fertility)

I considered this procedure in 2003 so let me share some of what I learned with you.

Women have successfully conceived and carried to term post-UAE (aka: UFE or embolization), however since there have no been many studies of the outcomes post procedure in women of child-bearing age many (if not most) doctors will not recommend it to their patient if they are wanting to have children afterwards. There have even been IVF pregnancies post UAE, though still, how many isn't well documented or studied.

Here's a link you might want to refer to, it treats the topic fairly:

I haven't looked into it in a while but as I recall the risks of the procedure specifically for this population include:

  • possible increase in risk of uterine rupture during pregnancy/delivery (small percentage)
  • possible misembolization of ovaries which could compromise their function or cause menopause
  • possible risk of infection from degenerated fibroid tissue
  • possible misembolization of pelvic blood flow compromising sexual function

The SIR (American Society of Interventional Radiologists) qualifications for UAE candidate selection excluded women of childbearing age at this time until there is more study of the outcomes, though it does include women who are unwilling to have surgery -- even they recognize that there is a grey area here (I spoke with the author and that is how I know this).

If you wanted to have the procedure done, I believe that you would want to have an MRI ahead of time (as to the specifications of the IR), and know that other conditions should be ruled out -- such as adenomyosis or cancer (as someone reminded me the other day). The IR I consulted with said that in his experience fibroids greater than 1cm but not larger than 8cm were ideal for the procedure as these have both a large enough blood supply and will shrink enough to have a positive affect. If you check on the embo list ( I bet you will find women there who have had the procedure with fibroids outside of that range.

I found doctors with differing opinions of the procedure myself, though I decided to try acupuncture and chinese medicine first (which did help to shrink my fibroid some over 4 months) only to get pregnant and have my fibroid double in size and cause problems that assured me that having a myomectomy was the best route for me in the end.

Good luck with your research and decision making.

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