Uterine artery embolisation also known as fibroid embolisation can help restore fertility in women with uterine fibroids, according to a new study published online in the journal Radiology.
Uterine fibroids are considered one of the most common causes of infertility and complications related to pregnancy. Previous research has found that one out of every four women with fibroids has problems related to fertility. The standard treatment option for such women is myomectomy, or surgical removal of the fibroids.
However, myomectomy is not always possible or effective and can result in major complications including hysterectomy, according to study co-author Joao Martins Pisco, Department of Interventional Radiology, Saint Louis Hospital in Lisbon, Portugal.
Despite its less invasive nature, uterine fibroid embolisation has yet to be fully embraced in the medical community as a fertility-preserving treatment for women with symptomatic fibroids due to concerns that the procedure may cause inadequate blood flow to the endometrium.
For the study, Pisco and colleagues assessed pregnancy rates in 359 women with uterine fibroids who were unable to conceive and who underwent either conventional or partial fibroid embolisation. After an average follow up of almost 6 years, 149 of the 359 women or 41.5% had become pregnant one or more times. It was the first pregnancy for more than 85% of the women who gave birth.
"Our findings show that uterine fibroid embolisation is a fertility-restoring procedure for women with uterine fibroids who wish to conceive, and pregnancy following uterine fibroid embolisation apprears to be safe with low morbidity", Pisco said. "Women who had been uable to conceive had normal pregnancies after uterine fibroid embolisation and similar complication rates as the general population in spite of being in a high-risk group."
Pisco suggested that embolisation may become the first-line treatment for women with fibroids who wish to conceive, particularly for those with numerous or very large fibroids. Such patients have a fibroid recurrance rate of more than 60% after myomectomy, making embolisation an important option. "In our study there are now almost 200 newborns following uterine fibroid embolisation," Pisco said. "Our next step will be a randomised study comparing the results of partial and conventional uterine fibroid embolisation".
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