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Uterine Artery Embolization and Its Effect on Fertility
Prasoon P. Mohan, MD, MRCS , Michael H. Hamblin, MD , Robert L. Vogelzang, MD
Journal of Vascular and Interventional Radiology, Volume 24, Issue 7, July 2013, Pages 925–930
Editor’s comment: Prof. Jim Thornton: Uterine artery embolization is a fairly well established treatment for uterine fibroids.
However there remain concerns about its effect on fertility This review of twelve studies after fibroid embolization and of nine studies after embolization for post-partum haemorrhage is reassuring. Although only one study was a randomised trial, the observed pregnancy rates, and pregnancy complication rates, were similar to those in the general population of the same age.
A systematic review of literature analyzing fertility following uterine artery embolization (UAE) is presented. Twenty-one studies describing pregnancy and complications of pregnancy following UAE were included. Low-level evidence from these studies suggests that pregnancy rates following UAE are comparable to the age-adjusted rates in the general population. Although pregnancy complication rates were similar to those in patients with untreated fibroid tumors, a few studies have reported higher miscarriage rates following UAE. Further randomized controlled trials comparing UAE versus other fertility-preserving treatments are necessary to confirm these findings.