May is National Menstrual Health Awareness Month. It’s a time dedicated to raising awareness about menstrual health and hygiene, advocating for equitable access to menstrual products, combating period stigma, and promoting education on reproductive health issues.
Uterine Fibroid Embolization, UFE, also known as Uterine Artery Embolization (UAE) is a non-surgical treatment for fibroids that provides relief and the reduction or complete treatment of fibroid symptoms. Uterine fibroids, which are also called leiomyomas, do not increase the risk of cancer. But when a woman of childbearing age is diagnosed with one or more fibroids in her uterus, fertility and pregnancy-related questions are at the top of her mind. Will the fibroids affect my fertility? Can I deliver a healthy baby? Do my fibroids put me at risk of miscarriage? Will my baby need to be delivered by C-section?
Uterine Fibroid Embolization (UFE) and Fertility
One out of four women with uterine fibroids experiences problems related to fertility. In such women, the chances of conception can be increased by treating the fibroids. Uterine Fibroid Embolization (UFE) is one of the treatment options available to women with fibroids. During the UFE procedure, the blood supply to the fibroids is cut off by placing tiny beads in the uterine arteries. This causes the fibroids to shrink and die.
Studies have shown that UFE can restore fertility in a significant percentage of women with uterine fibroids. Uterine fibroids affect approximately 1 in 2 women of reproductive age in the U.S.1. It has been estimated that as many as 50–70% of Caucasian women are affected by Fibroids. More than 80% of African American women will have uterine fibroids by the age of 50 2.
A UFE procedure is an ideal option as an alternative to a hysterectomy and as a means of preserving the uterus along with the potential for maintaining fertility. There are reports of fertility after a UFE procedure, however, more data is coming out that shows that a Uterine Fibroid Embolization is comparable to a Myomectomy.
Myomectomy and Fertility
Myomectomy is a common treatment for uterine fibroids. It involves surgical removal of the fibroids from the uterus. Myomectomy can be performed in several ways, depending on the number, size, and location of your fibroids.
Some patients with smaller and fewer fibroids may be candidates for laparoscopic (minimally-invasive) myomectomy, but many women require open abdominal surgery.
One of the potential complications of myomectomy is a rupture of the uterus during pregnancy or labor 3. Roughly 5% of women who undergo myomectomy suffer this complication. The fear of uterine rupture is the reason for a high rate of cesarean sections in pregnant patients who underwent myomectomy for fibroid treatment 3.
UFE vs. Myomectomy Procedure
Myomectomy surgically removes fibroids while preserving the uterus. It can be done through one incision or in some cases multiple incisions, in the vagina, cervix, or lower abdomen. There are three types of myomectomy procedures: abdominal, laparoscopic, or hysteroscopic surgery. The type of surgery depends on the size, location, and number of fibroids present. You can expect a myomectomy to take between 2-3 hours.
Uterine fibroid embolization, on the other hand, inserts a thin catheter through the upper thigh into the femoral artery. Then, small gel particles are injected into the blood vessels that supply blood to the fibroids. These particles block the blood supply to the fibroid, causing it to shrink. UFE is performed as a same-day procedure and usually takes around an hour to complete.
Can’t Decide Between a UFE vs Myomectomy?
UFE vs. Myomectomy Procedure
Myomectomy surgically removes fibroids while preserving the uterus. It can be done through one incision or in some cases multiple incisions, in the vagina, cervix, or lower abdomen. There are three types of myomectomy procedures: abdominal, laparoscopic, or hysteroscopic surgery. The type of surgery depends on the size, location, and number of fibroids present. You can expect a myomectomy to take between 2-3 hours.
Uterine fibroid embolization, on the other hand, inserts a thin catheter through the upper thigh into the femoral artery. Then, small gel particles are injected into the blood vessels that supply blood to the fibroids. These particles block the blood supply to the fibroid, causing it to shrink. UFE is performed as a same-day procedure and usually takes around an hour to complete.
References:
- Marsh EE, Al-Hendy A, Kappus D, Galitsky A, Stewart EA, Kerolous M. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt). 2018;27(11):1359-1367. doi:10.1089/jwh.2018.7076
- Eltoukhi HM, Modi MN, Weston M, Armstrong AY, Stewart EA. The health disparities of uterine fibroid tumors for African American women: a public health issue. Am J Obstet Gynecol. 2014;210(3):194-199. doi:10.1016/j.ajog.2013.08.008
- Desai P, Patel P. Fibroids, infertility and laparoscopic myomectomy. J Gynecol Endosc Surg. 2011;2(1):36-42. doi:10.4103/0974-1216.85280 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304294/