SIR: Pregnancy following fibroid embolization shows comparable fertility rates

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In the evaluation of pregnancy following uterine fibroid embolization (UFE), researchers from St. Louis Hospital in Lisbon have determined that most pregnancies present good outcomes with low morbidity rates, said João Martins Pisco, MD, interventional radiologist and lead author of the study, at the Society of Interventional Radiology's (SIR) 35th Annual Scientific Meeting in Tampa, Fla.

Pisco and colleagues found that minimally invasive UFE presents a comparable fertility rate to myomectomy in women. "These results are surprising because other studies have favored surgical myomectomy over UFE for women who want to conceive,” said Pisco.

In the retrospective study conducted in a single Portuguese institution, the researchers reviewed the cases of 743 patients who had chosen to undergo treatment for fibroids by way of UFE, in which polyvinyl alcohol particles or embozene microspheres were used to embolize the uterine arteries. Of this patient population, 74 women wanted to conceive and had been unable to following myomectomy, a commonly practiced method for women who wish to conceive following fibroid treatment.

The researchers said that 39 patients or 52.7 percent of the 74 women (with an age range of 29-43 years) became pregnant from two to 22 months (with an average of 10.8 months) following UFE treatment.  Of these pregnancies, there were 24 successful live births with 10 ongoing pregnancies. However, the authors reported at the conference that there have been 36 completed pregnancies, resulting in 30 births (83.3 percent) and there are seven ongoing pregnancies.

In addition, the gestation of the women ranged from 36 to 41 weeks, with an average of 39 weeks. The percentages of miscarriages (11.1 percent) pre-term delivery (10 percent) and low birth weight (13.3 percent) were found to be the same as the general population, said Pisco and colleagues. Moreover, all the infants born presented no significant neonatal problems, they said.

The authors said that due to the small population size, larger, multicentered, randomized prospective studies are required in order to compare UFE and myomectomy further.

"This study is significant because it shows comparable fertility rates between the two primary uterus-sparing treatments widely available to treat fibroids: uterine fibroid embolization (UFE) and surgical myomectomy, which is considered the gold standard for symptomatic fibroids in women who wish to conceive," concluded Pisco.