Minimally Invasive Procedure Treats Fibroids, Restores Fertility

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A minimally invasive treatment helps restore fertility in women with uterine fibroids, according to a recent study.

Uterine fibroids are abnormal masses of muscle and fiber tissue in the uterine wall. About one out of four women with uterine fibroids experiences problems with fertility.

The standard treatment is surgical removal of the fibroids called a myomectomy. Unfortunately, myomectomies are not always advised, nor are they consistently effective, and the procedure can cause severe complications, including hysterectomy.

A newer treatment, called uterine fibroid embolization (UFE), involves injecting an embolic agent, usually made of tiny beads, into a woman’s uterine arteries. This inhibits blood flow to the uterus and fibroids. As the fibroids shrivel and die, the uterus completely recovers.

Although the procedure is less invasive, the medical community is slow to accept UFE. There is a concern it may diminish the blood supply to the uterine lining (endometrium), and the ovaries.

In a recent study, Dr. Joao Martins Pisco, M.D., Ph.D., and colleagues monitored the pregnancy rates of 359 women who could not conceive owed to fibroids, and underwent a partial, or a complete UFE. A complete UFE blocks all uterine artery branches; the partial blocks only small vessels to the fibroids.

The follow-up, over nearly six years, revealed that 131 of the 359 women who had UFEs gave birth to a total of 150 children. For 85 percent of those who delivered, it was their first pregnancy.

“Our findings show that UFE is a fertility-restoring procedure in women with uterine fibroids who wish to conceive, and pregnancy following UFE appears to be safe with low morbidity,” said Dr. Pisco. “Women who had been unable to conceive had normal pregnancies after UFE and similar complication rates as the general population in spite of being in a high-risk group.”

Dr. Pisco believes UFE could become the treatment of choice for women with fibroids and fertility issues, especially those with numerous, or large fibroids. These individuals have more than a 60 percent fibroid recurrence rate following myomectomies, making UFE a valuable option.

“Our next step will be a randomized study comparing the results of partial and conventional UFE,” says Dr. Pisco.

Source: RSNA
Photo credit: Mrhayata


 
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