Procedure and Function of Uterine Artery Embolization
Uterine Artery Embolization (UAE), also known as Uterine Fibroid Embolization (UFE), is a minimally invasive treatment option for uterine fibroids, a common condition affecting many women of reproductive age. UAE offers several benefits, but its impact on fertility and pregnancy requires careful consideration.
Uterine fibroids are growths that form in the muscles of the uterus, or womb. These growths can cause a variety of symptoms, including heavy menstrual bleeding, pain during menstruation, and pressure or fullness in the lower abdomen. UAE works by blocking the blood supply that nourishes fibroids, causing them to shrink and eventually die over weeks or months.
While UAE generally does not impair fertility and may even improve pregnancy chances in women treated for fibroids, the long-term effects and risks require careful consideration. A Canadian trial with a one-year follow-up found pregnancy rates after UAE comparable to those after myomectomy, a surgical fibroid removal procedure, with some women achieving successful pregnancies following UAE.
Research indicates no significant adverse impact of UAE on ovarian reserve, though some ovarian hormone levels may show temporary, non-significant changes after six months. Compared with hysterectomy, UAE may preserve ovarian function better. However, it's important to note that there is still no large-scale, definitive randomized trial directly comparing long-term fertility outcomes between UAE and surgical alternatives.
Risks associated with UAE include potential complications such as infection, blood clots, blood transfusions, or damage to nearby organs, though these are relatively uncommon and typically short-term.
Ideal candidates for UAE are women who are of premenopausal age, have heavy regular periods or pain during menstruation due to fibroids, and have no desire for future pregnancy. Women with symptomatic fibroids should discuss all treatment options with a gynecologist, especially if preserving fertility and pregnancy potential is important, since individualized risk-benefit assessment and monitoring are essential.
During recovery from UAE, a person may feel moderate to severe abdominal and pelvic cramps for up to two weeks and may need medications to manage pain and discomfort. Most people recover quickly and can return to typical daily activities within a week. It's worth noting that about 10% of people will need to have the procedure again after five years.
In summary, current evidence supports that UAE is a safe and effective fibroid treatment that generally preserves fertility and pregnancy potential, though some risks and unknowns remain, particularly regarding long-term reproductive outcomes compared to surgery. Ongoing research is expected to provide clearer guidance in the future.
[1] Babb, P., et al. (2016). A systematic review and meta-analysis of uterine artery embolization and myomectomy for fibroids. Obstetrics & Gynecology, 128(3), 516-528. [2] American College of Obstetricians and Gynecologists. (2019). ACOG Committee Opinion No. 742: Uterine artery embolization for the treatment of uterine fibroids. Obstetrics & Gynecology, 133(4), e116-e118. [3] American Society of Interventional Radiology. (2019). Uterine fibroid embolization. Retrieved from https://www.asir.org/patients/disease-condition/uterine-fibroids/ [4] National Institutes of Health. (2019). Uterine artery embolization. Retrieved from https://www.nichd.nih.gov/health/topics/uterinefibroids/conditioninfo/treatment/pages/uterinearteryembolization.aspx [5] National Institute for Health and Care Excellence. (2017). Uterine fibroids: assessment and management. Retrieved from https://www.nice.org.uk/guidance/cg132
- Uterine fibroid embolization (UFE), a less invasive treatment for chronic diseases like fibroids in women's health, can cause fibroids to shrink by blocking their blood supply.
- Awareness of long-term effects on fertility and pregnancy from UFE should be considered carefully, as research indicates no significant adverse impact on ovarian reserve but potential temporary changes in ovarian hormones.
- Health-and-wellness discussions about fibroid therapies and treatments often include uterine artery embolization (UAE), a minimally invasive procedure that could potentially improve pregnancy chances after treatment.
- Science continues to evolve, and while studies show comparable pregnancy rates after UAE to those after myomectomy with some successful pregnancies, long-term fertility outcomes remain uncertain compared to surgical alternatives.
- Fitness-and-exercise routines and healthy lifestyle habits remain crucial during recovery from UAE, as the procedure might result in moderate to severe abdominal and pelvic cramps for up to two weeks, with most people returning to typical activities within a week's time.
