Pregnancy possible after fibroid treatment

NEW YORK (Reuters Health) - For young women with fibroids — benign tumors inside the uterus that can lead to pain, abnormal bleeding and other symptoms — a treatment called uterine artery embolization (UAE) does not harm fertility, according to results of a study conducted in Spain.

Hysterectomy, the traditional operation for fibroids, solves the problem of painful uterine fibroids by removing the uterus completely. With UAE, by contrast, a tiny catheter is used to inject small particles into the blood vessels feeding the tumors, thereby depriving them of blood and causing them to shrink. Because the uterus is not removed, UAE allows women the possibility of becoming pregnant in the future if desired.

Although studies have shown that the risk of “ovarian failure” is negligible (less than 1 percent) in UAE patients who are younger than 40 years of age, concern regarding the impact of UAE on a woman’s fertility lingers, the study team notes in the medical journal Fertility and Sterility.

To further characterize the effect of UAE on fertility, Dr. Isabel Pinto Pabon from Hospital de Madrid, Monteprincipe, and associates followed 100 women with painful uterine fibroids who were treated with UAE between 2002 and 2006.

Among 39 women age 40 and younger who wanted to remain fertile, there were 11 pregnancies in 10 women who conceived between 5 and 30 months following the procedure, including one woman who became pregnant twice, they report.

Two pregnancies were achieved by assisted reproduction techniques and nine were spontaneous.

There were three cases of miscarriage in two women, but this rate “does not appear to be higher than the rate for the general population,” the investigators emphasize.

SOURCE: Fertility and Sterility, December 2008.

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