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UAE is not Recommended for Women Wishing to Conceive

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Radiological Interventions in Obstetrics and Gynaecology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Although considered a fertility saving option in women of reproductive age, current evidence suggests that uterine artery embolization can have an adverse effect on ovarian function as well as on future pregnancies. Uterine artery embolization is associated with a risk of premature ovarian failure, as well as occasional injury to the endometrium resulting in endometrial atrophy and adhesion formation. All of these including a subtle reduction in the ovarian reserve jeopardise fertility. Pregnancies following uterine artery embolization can be complicated by an increased rate of miscarriage, preterm delivery, intra-uterine growth restriction, malpresentation, abnormal placentation and post-partum hemorrhage. In view of the possibility of impaired ovarian function as well as increased pregnancy complications, women with fibroids who wish to conceive should not be treated with uterine artery embolization. Myomectomy should be recommended as the treatment of choice over uterine artery embolization in women desiring future fertility. The effect of uterine artery embolization for post-partum hemorrhage on future fertility is currently uncertain.

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References

  • Agdi M, Valenti D, Tulandi T (2008) Intraabdominal adhesions after uterine artery embolization. Am J Obstet Gynecol 199(5):482 e1–3

    Google Scholar 

  • Bernard G, Darai E, Poncelet C, Benifla JL, Madelenat P (2000) Fertility after hysteroscopic myomectomy: effect of intramural myomas associated. Eur J Obstet Gynecol Reprod Biol 88(1):85–90

    PubMed  CAS  Google Scholar 

  • Burbank F, Hutchins FL Jr (2000) Uterine artery occlusion by embolization or surgery for the treatment of fibroids: a unifying hypothesis-transient uterine ischemia. J Am Assoc Gynecol Laparosc 7(4 Suppl):S1–S49

    Google Scholar 

  • Carpenter TT, Walker WJ (2005) Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. BJOG 112(3):321–325

    PubMed  CAS  Google Scholar 

  • Casini ML, Rossi F, Agostini R, Unfer V (2006) Effects of the position of fibroids on fertility. Gynecol Endocrinol 22(2):106–109

    PubMed  Google Scholar 

  • Chua GC, Wilsher M, Young MPA, Manyonda I, Morgan R, Belli AM (2005) Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization. Clin Radiol 60(1):116–122

    PubMed  CAS  Google Scholar 

  • Cordonnier C, Ha-Vien DE, Depret S, Houfflin-Debarge V, Provost N, Subtil D (2002) Foetal growth restriction in the next pregnancy after uterine artery embolisation for post-partum haemorrhage. Eur J Obstet Gynecol Reprod Biol 103(2):183–184

    PubMed  Google Scholar 

  • Cottier JP, Fignon A, Tranquart F, Herbreteau D (2002) Uterine necrosis after arterial embolization for postpartum hemorrhage. Obstet Gynecol 100(5 Pt 2):1074–1077

    PubMed  CAS  Google Scholar 

  • Deux JF, Bazot M, Berkane N, Maillet M, Boudghene F, Uzan S (2000) Postpartum hemorrhage: treatment by embolization. Gynecol Obstet Fertil 28(10):711–718

    PubMed  CAS  Google Scholar 

  • Deux JF, Bazot M, Le Blanche AF, Tassart M, Khalil A, Berkane N, Uzan S, Boudghene F (2001) Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage? AJR Am J Roentgenol 177(1):145–149

    PubMed  CAS  Google Scholar 

  • Farhi J, Ashkenazi J, Feldberg D, Dicker D, Orvieto R, Ben Rafael Z (1995) Effect of uterine leiomyomata on the results of in vitro fertilization treatment. Hum Reprod 10(10):2576–2578

    PubMed  CAS  Google Scholar 

  • Gaia G, Chabrot P, Cassagnes L, Calcagno A, Gallot D, Botchorishvili R, Canis M, Mage G, Boyer L (2009) Menses recovery and fertility after artery embolization for PPH: a single-center retrospective observational study. Eur Radiol 19(2):481–487

    PubMed  CAS  Google Scholar 

  • Goldberg J, Pereira L, Berghella V, Diamond J, Darai E, Seinera P, Seracchioli R (2004) Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol 191(1):18–21

    PubMed  Google Scholar 

  • Hardeman S, Decroisette E, Marin B, Vincelot A, Aubard Y, Pouquet M, Maubon A (2010) Fertility after embolization of the uterine arteries to treat obstetrical hemorrhage: a review of 53 cases. Fertil Steril 94(7):2574–2579

    PubMed  Google Scholar 

  • Hehenkamp WJ, Volkers NA, Broekmans FJ, de Jong FH, Themmen AP, Birnie E, Reekers JA, Ankum WM (2007) Loss of ovarian reserve after uterine artery embolization: a randomized comparison with hysterectomy. Hum Reprod 22(7):1996–2005

    PubMed  CAS  Google Scholar 

  • Holub Z, Mara M, Kuzel D, Jabor A, Maskova J, Eim J (2008) Pregnancy outcomes after uterine artery occlusion: prospective multicentric study. Fertil Steril 90(5):1886–1891

    PubMed  Google Scholar 

  • Homer H, Saridogan E (2010) Uterine artery embolization for fibroids is associated with an increased risk of miscarriage. Fertil Steril 94(1):324–330

    PubMed  Google Scholar 

  • Kuzel D, Mara M, Horak P, Kubinova K, Maskova J, Dundr P, Cindr J (2011) Comparative outcomes of hysteroscopic examinations performed after uterine artery embolization or laparoscopic uterine artery occlusion to treat leiomyomas. Fertil Steril 95(6):2143–2145

    PubMed  Google Scholar 

  • Lee JS, Shepherd SM (2010) Endovascular treatment of postpartum hemorrhage. Clin Obstet Gynecol 53(1):209–218

    PubMed  Google Scholar 

  • Lefebvre G et al (2003) The management of uterine leiomyomas. J Obstet Gynaecol Can 25(5):396–418; quiz 19–22

    Google Scholar 

  • Mara M, Maskova J, Fucikova Z, Kuzel D, Belsan T, Sosna O (2008) Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol 31(1):73–85

    PubMed  Google Scholar 

  • Merland JJ, Houdart E, Herbreteau D, Trystram D, Ledref O, Aymard A, Bouret JM, Ravina JH (1996) Place of emergency arterial embolisation in obstetric haemorrhage about 16 personal cases. Eur J Obstet Gynecol Reprod Biol 65(1):141–143

    PubMed  CAS  Google Scholar 

  • Mitty HA, Sterling KM, Alvarez M, Gendler R (1993) Obstetric hemorrhage: prophylactic and emergency arterial catheterization and embolotherapy. Radiology 188(1):183–187

    PubMed  CAS  Google Scholar 

  • Opinion ACOG Committee (2004) Uterine artery embolization. Obstet Gynecol 103(2):403–404

    Google Scholar 

  • Pelage JP, Le Dref O, Mateo J, Soyer P, Jacob D, Kardache M, Dahan H, Repiquet D, Payen D, Truc JB, Merland JJ, Rymer R (1998) Life-threatening primary postpartum hemorrhage: treatment with emergency selective arterial embolization. Radiology 208(2):359–362

    PubMed  CAS  Google Scholar 

  • Picone O, Salomon LJ, Ville Y, Kadoch J, Frydman R, Fernandez H (2003) Fetal growth and Doppler assessment in patients with a history of bilateral internal iliac artery embolization. J Matern Fetal Neonatal Med 13(5):305–308

    PubMed  CAS  Google Scholar 

  • Pirard C, Squifflet J, Gilles A, Donnez J (2002) Uterine necrosis and sepsis after vascular embolization and surgical ligation in a patient with postpartum hemorrhage. Fertil Steril 78(2):412–413

    PubMed  Google Scholar 

  • Pritts EA, Parker WH, Olive DL (2009) Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 91(4):1215–1223

    PubMed  Google Scholar 

  • Pron G, Mocarski E, Bennett J, Vilos G, Common A, Vanderburgh L (2005) Pregnancy after uterine artery embolization for leiomyomata: the Ontario multicenter trial. Obstet Gynecol 105(1):67–76

    PubMed  Google Scholar 

  • Salomon LJ, deTayrac R, Castaigne-Meary V, Audibert F, Musset D, Ciorascu R, Frydman R, Fernandez H (2003) Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study. Hum Reprod 18(4):849–852

    PubMed  CAS  Google Scholar 

  • Shokeir TA (2005) Hysteroscopic management in submucous fibroids to improve fertility. Arch Gynecol Obstet 273(1):50–54

    PubMed  Google Scholar 

  • Somigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG (2007) Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update 13(5):465–476

    PubMed  CAS  Google Scholar 

  • Spies JB, Allison S, Flick P, Cramp M, Bruno J, Jha RC, Ascher SA (2005a) Spherical polyvinyl alcohol versus tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a limited randomized comparative study. J Vasc Interv Radiol 16(11):1431–1437

    PubMed  Google Scholar 

  • Spies JB, Bruno J, Czeyda-Pommersheim F, Magee ST, Ascher SA, Jha RC (2005b) Long-term outcome of uterine artery embolization of leiomyomata. Obstet Gynecol 106(5 Pt 1):933–939

    PubMed  Google Scholar 

  • Spies JB, Cornell C, Worthington-Kirsch R, Lipman JC, Benenati JF (2007) Long-term outcome from uterine fibroid embolization with tris-acryl gelatin microspheres: results of a multicenter study. J Vasc Interv Radiol 18(2):203–207

    PubMed  Google Scholar 

  • Spies JB, Myers ER, Worthington-Kirsch R, Mulgund J, Goodwin S, Mauro M (2005c) The FIBROID registry: symptom and quality-of-life status 1 year after therapy. Obstet Gynecol 106(6):1309–1318

    PubMed  Google Scholar 

  • Tropeano G, Amoroso S, Scambia G (2008) Non-surgical management of uterine fibroids. Hum Reprod Update 14(3):259–274

    PubMed  Google Scholar 

  • Tropeano G, Litwicka K, Di Stasi C, Romano D, Mancuso S (2003) Permanent amenorrhea associated with endometrial atrophy after uterine artery embolization for symptomatic uterine fibroids. Fertil Steril 79(1):132–135

    PubMed  Google Scholar 

  • Tulandi T (2007) Treatment of uterine fibroids—is surgery obsolete? N Engl J Med 356(4):411–413

    PubMed  CAS  Google Scholar 

  • Tulandi T, Salamah K (2010) Fertility and uterine artery embolization. Obstet Gynecol 115(4):857–860

    PubMed  Google Scholar 

  • Tulandi T, Sammour A, Valenti D, Child TJ, Seti L, Tan SL (2002) Ovarian reserve after uterine artery embolization for leiomyomata. Fertil Steril 78(1):197–198

    PubMed  Google Scholar 

  • Vilos GA, Vilos EC, Romano W, Abu-Rafea B (2006) Temporary uterine artery occlusion for treatment of menorrhagia and uterine fibroids using an incisionless Doppler-guided transvaginal clamp: case report. Hum Reprod 21(1):269–271

    PubMed  CAS  Google Scholar 

  • Walker WJ, McDowell SJ (2006) Pregnancy after uterine artery embolization for leiomyomata: a series of 56 completed pregnancies. Am J Obstet Gynecol 195(5):1266–1271

    PubMed  Google Scholar 

  • Yamashita Y, Harada M, Yamamoto H, Miyazaki T, Takahashi M, Miyazaki K, Okamura H (1994) Transcatheter arterial embolization of obstetric and gynaecological bleeding: efficacy and clinical outcome. Br J Radiol 67(798):530–534

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada

    Mausumi Das & Togas Tulandi

Authors
  1. Mausumi Das
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  2. Togas Tulandi
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Correspondence to Togas Tulandi .

Editor information

Editors and Affiliations

  1. Department of Radiology, Guy’s Hospital, London, UK

    John Reidy

  2. Department of Clinical Radiology, Southampton General Hospital, Southampton, UK

    Nigel Hacking

  3. Los Angeles Fibroid Treatment Center, Los Angeles, CA, USA

    Bruce McLucas

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© 2013 Springer Berlin Heidelberg

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Das, M., Tulandi, T. (2013). UAE is not Recommended for Women Wishing to Conceive. In: Reidy, J., Hacking, N., McLucas, B. (eds) Radiological Interventions in Obstetrics and Gynaecology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_851

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  • DOI: https://doi.org/10.1007/174_2013_851

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27974-4

  • Online ISBN: 978-3-642-27975-1

  • eBook Packages: MedicineMedicine (R0)

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