Study Shows Comparable Fertility Rates for Uterine Fibroid Embolization and Surgical Myomectomy

March 15, 2010—A study was presented at the Society of Interventional Radiology's 35th annual scientific meeting in Tampa, Florida, that showed uterine fibroid embolization (UFE) treatment results in a comparable fertility rate to myomectomy for women who want to conceive.

Investigator João Martins Pisco, MD, commented, "This study is significant because it shows comparable fertility rates between the two primary uterus-sparing treatments widely available to treat fibroids: UFE and surgical myomectomy, which is considered the gold standard for symptomatic fibroids in women who wish to conceive. These results are surprising because other studies have favored surgical myomectomy over UFE for women who want to conceive."

According to Dr. Pisco, in this study of 743 women, UFE had a fertility rate of 58.1%, which is comparable to myomectomy, which has a fertility rate of 57%. "Our study proves that UFE not only allows women who were unable to conceive to become pregnant but also allows them to have normal pregnancies with similar complication rates as the general population in spite of being a high-risk group," he added. "In the future, UFE will probably be a first-line treatment option even for women who wish to conceive and are unable due to the presence of uterine fibroids," he noted. "We want women to know that uterine fibroids may be a cause of infertility, that their treatment is mandatory, and that UFE may be the only effective treatment for some women." 

In the Portuguese study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization because hysterectomy was the only suggested option. Of the 743 patients who received UFE treatment, 74 wanted to conceive and had been unable. Of these 74 women, 43 or 58.1% (average age, 36.2) became pregnant; the time between UFE and conception ranged from 2 to 22 months. At this time, there have been 36 completed pregnancies, resulting in 30 births (83.3%); seven women are still pregnant.

"Most of the pregnancies after UFE had good outcomes with few complications," observed Dr. Pisco. "The complication rate of the pregnancies was expected to be higher than the general population because these were high-risk patients who had already undergone fertility treatments and were unable to conceive. However, the percentage of the spontaneous abortions (11.1%), preterm delivery (10%), and low birth weight (13.3%) was the same as the general population."

This was a small retrospective study based on patients being treated for fibroids by UFE in a single institution; larger, multicentered, randomized prospective studies are needed to compare UFE and myomectomy, concluded Dr. Pisco.