» Articles » PMID: 26633901

Uterine Fibroid Embolisation - Potential Impact on Fertility and Pregnancy Outcome

Overview
Date 2015 Dec 4
PMID 26633901
Citations 5
Authors
Affiliations
Soon will be listed here.
Abstract

The current standard therapy to treat myomas in women wishing to have children consists of minimally invasive surgical myomectomy. Uterine artery embolisation (UAE) has also been discussed as another minimally invasive treatment option to treat myomas. This review evaluates the literature of the past 10 years on fibroid embolisation and its impact on fertility and pregnancy. Potential problems associated with UAE such as radiation exposure of the ovaries, impairment of ovarian function and the impact on pregnancy and child birth are discussed in detail. Previously published reports of at least 337 pregnancies after UAE were evaluated. The review concludes that UAE to treat myomas can only be recommended in women with fertility problems due to myomas who refuse surgery or women with an unacceptably high surgical risk, because the evaluated case reports and studies show that UAE significantly increases the risk of spontaneous abortion; there is also evidence of pathologically increased levels for other obstetric outcome parameters. There are still very few prospective studies which provide sufficient evidence for a definitive statement on the impact of UAE therapy on fertility rates and pregnancy outcomes.

Citing Articles

Ovarian reserve after uterine artery embolization in women with morbidly adherent placenta: A cohort study.

Mohr-Sasson A, Spira M, Rahav R, Manela D, Schiff E, Mazaki-Tovi S PLoS One. 2018; 13(11):e0208139.

PMID: 30496259 PMC: 6264507. DOI: 10.1371/journal.pone.0208139.


Fertility and Pregnancy Outcome after Myoma Enucleation by Minilaparotomy under Microsurgical Conditions in Pronounced Uterus Myomatosus.

Floss K, Garcia-Rocha G, Kundu S, von Kaisenberg C, Hillemanns P, Schippert C Geburtshilfe Frauenheilkd. 2015; 75(1):56-63.

PMID: 25684787 PMC: 4318730. DOI: 10.1055/s-0034-1396163.


Surgical and Conservative Management of Symptomatic Leiomyomas during Pregnancy: a Retrospective Pilot Study.

Rothmund R, Taran F, Boeer B, Wallwiener M, Abele H, Campo R Geburtshilfe Frauenheilkd. 2014; 73(4):330-334.

PMID: 24771919 PMC: 3864456. DOI: 10.1055/s-0032-1328437.


High-Intensity Focused Ultrasound Ablation of Uterine Fibroids - Potential Impact on Fertility and Pregnancy Outcome.

Bohlmann M, Hoellen F, Hunold P, David M Geburtshilfe Frauenheilkd. 2014; 74(2):139-145.

PMID: 24741124 PMC: 3973937. DOI: 10.1055/s-0033-1360311.


Natural Size Development of Myomata - Ultrasound Observational Study of 55 Premenopausal Patients.

David M, Adams L, Stupin J Geburtshilfe Frauenheilkd. 2014; 74(1):75-80.

PMID: 24741122 PMC: 3964357. DOI: 10.1055/s-0033-1351072.

References
1.
DAngelo A, Amso N, Wood A . Spontaneous multiple pregnancy after uterine artery embolization for uterine fibroid: case report. Eur J Obstet Gynecol Reprod Biol. 2003; 110(2):245-6. DOI: 10.1016/s0301-2115(03)00190-8. View

2.
McLucas B, Adler L, Perrella R . Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids. J Am Coll Surg. 2001; 192(1):95-105. DOI: 10.1016/s1072-7515(00)00738-9. View

3.
Tropeano G, Litwicka K, Di Stasi C, Romano D, Mancuso S . Permanent amenorrhea associated with endometrial atrophy after uterine artery embolization for symptomatic uterine fibroids. Fertil Steril. 2003; 79(1):132-5. DOI: 10.1016/s0015-0282(02)04400-x. View

4.
Memtsa M, Homer H . Complications associated with uterine artery embolisation for fibroids. Obstet Gynecol Int. 2011; 2012:290542. PMC: 3236395. DOI: 10.1155/2012/290542. View

5.
Marshburn P, Matthews M, Hurst B . Uterine artery embolization as a treatment option for uterine myomas. Obstet Gynecol Clin North Am. 2006; 33(1):125-44. DOI: 10.1016/j.ogc.2005.12.009. View