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Pregnancy Possible After Fibroid Embolization : Uterine fibroid embolization is not the contraindication to conception it was thought to be.


 

From the annual meeting of the Society of Interventional Radiology

Major Finding: Of the more than half of women who became pregnant after uterine fibroid embolization, 30 women had successful live births and seven pregnancies are ongoing; there were five abortions (one induced and four spontaneous) and one stillbirth.

Data Source: A study of 74 women who underwent UFE.

Disclosures: None was reported.

TAMPA — Pregnancy rates following treatment with uterine fibroid embolization are comparable to those with myomectomy, offering hope for women who choose embolization but still want to conceive, study results showed.

“Uterine fibroid embolization [UFE] is not a contraindication in patients who want to conceive,” Dr. Joao-Martins Pisco said at the meeting.

The fertility rate in a small population of women who underwent UFE was comparable to that reported for myomectomy—58% vs. 57%.

Dr. Pisco reported on 74 women who underwent UFE but still wished to become pregnant. More than half of the women (58%) had spontaneous pregnancies following the procedure. They ranged in age from 29 to 43 years (mean age, 36 years).

UFE is typically offered to women who no longer wish to become pregnant, and myomectomy is usually offered to women who still wish to become pregnant.

However, there are limited data on fertility rates and pregnancy outcomes following UFE to support this practice, said Dr. Pisco, an interventional radiologist at St. Louis Hospital in Lisbon.

None of the women in this series had been able to conceive prior to UFE. Before the procedure, the women were informed of the uncertain effect of UFE on fertility and pregnancy.

Polyvinyl alcohol particles or Embozene microspheres were used to embolize the uterine arteries.

The mean size of the dominant fibroid was 151 cc. The women were cautioned to wait at least 6 months before trying to conceive.

In all, 30 women (84%) had successful live births. Two of these babies (7%)were born prematurely. There were five abortions—one induced and four spontaneous.

One stillbirth occurred in a woman who had previously undergone five myomectomies and who had conceived through in vitro fertilization.

Seven of the remaining pregnancies are ongoing.

Dr. Pisco noted that larger, multicenter, randomized prospective studies are needed comparing UFE and myomectomy.

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