- Uterine fibroids are benign tumors composed of muscle and fibrous
tissue and one of the most common causes of infertility and pregnancy
related complications in women.
- Minimally invasive uterine fibroid embolization (UFE) procedure has
proved to be safe and effective in restoring fertility in a majority of
women with fibroids.
of uterine fibroids is a safe procedure to treat infertility in women and could
become the first line of treatment for many women in future, according to a
study conducted by João Martins Pisco, M.D., Ph.D and his team
from the Department of
Interventional Radiology at Saint Louis Hospital in Lisbon, Portugal. The study
has been published online in the journal Radiology.
Choose Uterine Fibroid Embolization to Treat Infertility?
are one of the most common reasons for infertility in women.
Currently, the treatment of fibroids in women who wish to conceive is myomectomy or surgical removal of the
. However, these have been found to be associated with complications
that may sometimes necessitate
hysterectomy or removal of the uterus.
study was conducted with the purpose of assessing the safety and efficacy of
uterine fibroid embolization
non-surgical procedure to treat infertility in women with uterine fibroids.
‘Uterine fibroid embolization (UFE) could become the first line of treatment of fibroids in the future, especially in women of the reproductive age group who wish to conceive.’
Assessing the Efficacy of Uterine Fibroid Embolization
- The Study
the study, the research team assessed the pregnancy rates in 359 women
suffering from infertility
due to fibroids. They had undergone either a partial or a conventional UFE.
In conventional embolization, all the
uterine artery branches are embolized; in a partial UFE, only the small vessels
supplying the fibroids are embolized, without affecting the major branches. Understandably, the complications
associated with partial UFE are less in comparison to the conventional UFE.
The following were the observations of
the study over a six year follow-up
- Of the 359 women, 149 or 41.5%, achieved
pregnancy one or more times.
- Overall, 131 women gave birth to a
total of 150 babies.
- For more than 85% of the
women who gave birth, it was their first pregnancy.
- Complications following partial
embolization were 14.6% while post conventional UFE the rate of complicaton was 23.1 percent.
- The procedure was repeated in 28
patients in whom the fibroids had not been fully treated, as determined by
MRI, and 11 of those patients subsequently became pregnant.
- Before the publication of their
study, 12 more pregnancies were reported.
"Our findings show that UFE is a
fertility-restoring procedure in women with uterine fibroids who wish to
conceive, and pregnancy following UFE appears to be safe with low
morbidity," Dr. Pisco said. "Women who had been unable to conceive
had normal pregnancies after UFE and similar complication rates as the general
population in spite of being in a high-risk group."
About the Uterine Fibroid Embolization
The UFE or uterine artery embolization
procedure is a non-surgical procedure to treat fibroids. It is performed by a radiologist. The
uterine artery and its branches are visualized by injection of a contrast dye.
Under imaging guidance, an embolic agent composed of small bead like particles
is injected into the uterine artery branches to cut off the blood supply of the
fibroid and cause it to undergo shrinkage or atrophy.
spite of its non-invasive nature, concerns have been raised
about the risk of affecting blood supply to the ovaries and the uterine
endometrium. However, a well-trained and skilled doctor can embolize only the
uterine artery branches feeding the fibroids. This reduces the incidence of
Interestingly, UFE can be performed in
women who have undergone prior myomectomy or in-vitro fertilization.
In conclusion, the study authors opine
that in the future, uterine artery embolization could become the first line of
treatment in women with multiple or large fibroids, especially since the rate
of recurrence following myomectomy is rather high (nearly 60%), making UFE a highly preferred option.
"In our study there are now almost
200 newborns following UFE," Dr. Pisco said. "Our next step will be a
randomized study comparing the results of partial and conventional UFE.
- Uterine artery embolization - (https://medlineplus.gov/ency/article/007384.htm)