UAE is not Recommended for Women Wishing to Conceive
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 associat
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Contents 1
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.
Introduction.......................................................................... 143
2 Uterine Artery Embolization for Uterine Myomas......... 143 2.1 Fertility After Uterine Artery Embolization for Uterine Myomas.................................................................................. 144 2.2 Pregnancy After Uterine Artery Embolization for Uterine Myomas .............................................................. 145 3
Uterine Artery Embolization for Post-Partum Hemorrhage.......................................................................... 145 3.1 Fertility After Uterine Artery Embolization for Post-Partum Hemorrhage ................................................ 146 3.2 Pregnancy Outcome After Uterine Artery Embolization for Post-Partum Hemorrhage ................................................ 146 4
Alternative Radiological Techniques................................. 147
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Conclusions ........................................................................... 147
References...................................................................................... 147
1
M. Das T. Tulandi (&) Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada e-mail: [email protected]
Introduction
Uterine artery embolization is a vascular radiological procedure, which in recent years has gained recognition as a treatment option in the management of uterine myomas and post-partum hemorrhage. Although it aims to keep the uterus intact and is often regarded as a fertility conserving option in women of reproductive age, evidence suggests that uterine artery embolization can have an adverse impact on fertility.
J. Reidy et al. (eds.), Radiological Interventions in Obstetrics and Gynaecology, Medical Radiology. Diagnostic Imaging, DOI: 10.1007/174_2013_851, Springer Berlin Heidelberg 2013 Published Onli
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