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 For the study, researchers followed 359 women for an average of
almost six years after they had what’s known as uterine fibroid
embolization, when doctors destroy fibroids by blocking the arteries
supplying them with blood. By the end of the study, 149 of the
women, or 42 percent, had become pregnant one or more times, and 131
women had a total of 150 live births.
“Uterine embolization procedure is a controversial matter because it
is still seen as a risk to fertility,” said lead study author Dr.
Joao Martins Pisco, a researcher at New University of Lisbon.
“With this study we were able to verify that women who could not
conceive due to uterine fibroids, once subjected to embolization,
could have a normal pregnancy with a live newborn,” Martins Pisco
said by email.
Uterine fibroids, abnormal masses of fiber and muscle tissue in the
wall of the uterus, are one of the most common causes of infertility
and pregnancy complications, the study team writes in the journal
Radiology. Previous research has found that one out of every four
women with fibroids has problems related to fertility.
The standard treatment is myomectomy, a surgery that involves
cutting through the skin on the lower abdomen to reach the uterus
and removing fibroids from the uterine wall. This procedure isn’t
always effective, and it can sometimes lead to complications that
require a hysterectomy - surgical removal of all or part of the
uterus.
While embolization is less invasive and can be done in women who
have already had a myomectomy, some doctors have avoided this option
out of a concern that it may restrict blood flow to the lining of
the uterus and ovaries, making it harder for women to have babies,
researchers note.
In the current study, conducted at a single medical center in
Portugal, about 32 percent of the women had at least one previous
pregnancy and 20 percent had a live birth at least once before.
Overall, 79 percent of the women had an improvement in
fibroid-related symptoms, the study found. About 15 percent of women
had complications with partial embolization, when only small vessels
to the fibroids are blocked, and roughly 23 percent had problems
with full embolization, when all uterine artery branches are
blocked.
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In 28 cases, women needed repeat embolization procedures because the
fibroids weren’t fully treated.
The study wasn’t a controlled experiment designed to prove that
embolization is better than other fibroid treatments. Another
limitation is that all of the embolization procedures were done at a
single site, making it possible that results would be different at
other hospitals or surgical centers, the authors note.
Even so, the results suggest that women may want to consider
embolization for fibroids when they’re struggling to conceive,
especially if they want to avoid the risk of hysterectomy with more
invasive fibroid surgery, Martins Pisco said.
Fibroids won’t always get in the way of conception, however, and
women should be sure to rule out other causes of infertility if they
are only considering surgery to improve their chances of having a
baby, said Dr. Mikulas Redecha, a researcher at the University
Hospital Bratislava in Slovakia who wasn’t involved in the study.
Women should also avoid putting off pregnancy, Redecha added by
email.
“With increasing age, the chances for spontaneous conception
decrease and the chance of developing a fibroid increases,” Redecha
said. “If you have a fibroid, that does not automatically mean that
getting pregnant spontaneously is impossible.”
SOURCE: http://bit.ly/2uKkpwR Radiology, online June 13, 2017.
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