Many prior studies have shown pregnancy is possible after Uterine Fibroid Embolisation(UFE). Overall, meta-analysis suggests that the pregnancy rate post-UFE is in the range of 30-48%. There is a small risk of ovarian failure of 1-3% following UFE in women younger than 40 years of age. In other words, 97-99% of the time her ovaries are not injured with UFE.

Although a successful pregnancy outcome is possible after UFE, this is a complex issue. The presence of fibroids may make it difficult to get pregnant, cause potential miscarriage and present difficulties with normal vaginal delivery.

Traditionally, a myomectomy is recommended if fibroids are thought to be interfering with fertility and pregnancy. A myomectomy is still a major surgery and is generally technically more challenging than a hysterectomy. Risk of blood transfusion is higher than with a hysterectomy, and the risk of hysterectomy remains if the surgeon is unable to control bleeding during surgery. Recurrence of fibroid after myomectomy is not uncommon. Recurrence of fibroid after UFE is exceedingly rare, as all fibroids are treated in on go, large or tiny.

For those fibroids unsuitable for a myomectomy or hysteroscopic resection, UFE should be considered as an option for treatment. UFE can also be part of the overall strategy to treat challenging fibroids. After UFE, the fibroids are shrunken and devascularised (blood supply shut down), potentially making challenging fibroid surgery much safer and easier. If there were multiple fibroids, the surgeon can be more selective, removing only the larger ones and those ones in critical locations, leaving the smaller ones alone (as there were already been treated by UFE).

Following UFE,  the uterus can be conserved.  One needs to produce eggs to conceive. Recent studies from Dr McLucas showed UAE does not affect ovarian reserve in women <40 as evidenced by no significant change in AMH levels after UFE.  Women who are of reproductive age and have uterine fibroids can consider UAE without concern for adverse effects on their fertility. However, women need to be aware that even women younger than 40 needs might have 1 – 3% chance of early menopause ( that might be just age related).

Egg harvesting should be considered as an option. There is the concern that egg stimulation might cause further fibroid growth and that large fibroids might interfere with egg harvesting procedure.

It should be emphasised that the aim of UFE is to provide fibroids treatment with a minimally invasive technique, in order to avoid a hysterectomy. Although pregnancy is still possible after UFE, successful pregnancy depends on many other factors and therefore cannot be guaranteed.

You can estimate your fertility potential purely based on your and your partner’s age by using this IVF success estimator.

By ticking “I have not had any tests carried out, or I do not have medical infertility” ,  the estimate will ignore the uterine disease that you  might have, assuming you had a normal uterus. If you have a uterine disease such as fibroid or adenomyosis, the real fertility potential will be less than the estimate.

A Very Good Article from Fibroid Treatment Collective  on this issue

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