What should I think about if I have uterine fibroid embolization (UFE)?

UFE may not be a good choice if you want to get pregnant. It's possible to get pregnant afterward, but it's uncertain how good the odds are. This procedure does have a risk of damaging an ovary or the uterus, which would make it much harder to get pregnant. There may be a higher risk for pregnancy problems.

For a uterine fibroid embolization, be sure that you have a specially trained interventional radiologist who has a lot of experience with the procedure.

Uterine fibroid embolization may be a good treatment option for women who do not wish to receive blood transfusions (which can be needed after myomectomy) or who have other serious health conditions that make general anesthesia dangerous. UFE is not safe for women who are allergic to contrast material (used for fluoroscopy during UFE).

UFE has several advantages over hysterectomy, myomectomy and treatment with GnRH-a (the hormone-suppressor medicine used to shrink fibroids).

• General anesthesia and an abdominal (belly) incision are not required.
• There is no blood loss, so there is no need for blood transfusions.
• All fibroids may be treated at the same time.
• It does not cause bone-thinning (osteopenia) or the other serious side effects associated with GnRH-a therapy.

Disadvantages of UFE include:

• Cost. UFE is as expensive as hysterectomy.
• An unpredictable effect on fertility. It is not recommended for women who hope to become pregnant.
• The possibility of delayed infection sometime in the first year, which can become life-threatening if not treated.
• Not being a sure cure. In one study, nearly 1 out of 5 women who had UFE had a repeat UFE or a hysterectomy.
• The possibility that some insurance plans will not cover this procedure.

Interventional Radiologists (IR) are the physicians that perform the UFE procedure. You should seek out the IR who has the most UFE experience in your area. If there is not an IR with a significant UFE experience in your area, The Society of Interventional Radiology (SIR) website (www.sirweb.org) can find such a physician. It lists IRs from every state which is then alphabetized by city and last name. Those IR physicians with Fellowship status (FSIR after their name) have been recognized by the Society as leaders in the field of IR. You should ask the IR if he or she will perform the procedure (vs. supervising a resident or other physician), how many UFE procedures they have performed (hopefully hundreds or thousands), and who will care for you following the procedure (the IR or IR's colleague and not your Gynecologist or other physician).