Fertility in women with uterine fibroids after uterine artery embolization

Background. Uterine artery embolization (UAE) is currently widely used to treat uterine fibroids. Despite this, the issue of the effect of UAE on reproductive function remains controversial. Aim. To study the impact of EMA performed for uterine fibroids on women's reproductive function. Materials and methods. A retro- and prospective analysis of the case histories of 100 patients aged 26 to 45 years who underwent UAE for uterine fibroids was conducted. Results. In the majority of cases (96 %), UAE was effective. Repeated UAE was required only in 4 % of patients. Eight (8 %) patients underwent transcervical myomectomy during the first year after UAE. One (1 %) patient underwent laparoscopic myomectomy, one (1 %) – hysterectomy for fibroid necrosis in the second year of observation. Regular menstrual cycle after UAE was observed in 80 % of women, 18 % had an irregular menstrual cycle, which was restored within 12 months after surgery. And 2 % at the age of 45, experienced menopause. Pregnancy occurred in 58 % of patients. 34 (58.5 %) of pregnancies resulted in the first live birth. 13 (21.9 %) were terminated at the request of the women. In 3 (4.9 %) of cases, pregnancy ended in spontaneously miscarriage. In 5 (9.8 %) and 3 (4.9 %) of cases, non-viable and ectopic pregnancy was detected, respectively. The frequency of complications during pregnancy, childbirth and postpartum period in our study did not differ from those in the general population. Conclusion. The use of UAE for the treatment of uterine fibroids in patients of reproductive age planning pregnancy is highly effective alternative to surgical and drug treatment.