Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors

To evaluate the fertility of women eligible for surgical multiple myomectomy, but who carefully elected a fertility-sparing uterine artery embolization (UAE). Non-comparative open-label trial, on women ae40 years, presenting with multiple symptomatic fibroids (at least 3, ae3 cm), immediate pregnancy wish, and no associated infertility factor. Women had a bilateral limited UAE using tris-acryl gelatin microspheres ae500 mu m. Fertility, ovarian reserve, uterus and fibroid sizes, and quality of life questionnaires (UFS-QoL) were prospectively followed. Fifteen patients, aged 34.8 years (95%CI 32.2-37.5, median 36.0, q1-q3 29.4-39.5) were included from November 2008 to May 2012. During the year following UAE, 9 women actively attempting to conceive experienced 5 live-births (intention-to-treat fertility rate 33.3%, 95%CI 11.8%-61.6%). Markers of ovarian reserve remained stable. The symptoms score was reduced by 66% (95%CI 48%-85%) and the quality of life score was improved by 112% (95%CI 21%-204%). Uterine volume was reduced by 38% (95%CI 24%-52%). Women were followed for 43.1 months (95%CI 32.4-53.9), 10 live-births occurred in 8 patients, and 5 patients required secondary surgeries for fibroids. Women without associated infertility factors demonstrated an encouraging capacity to deliver after UAE. Further randomized controlled trials comparing UAE and myomectomy are warranted. aEuro cent Women without infertility factors showed an encouraging delivery rate after UAE. aEuro cent For women choosing UAE over abdominal myomectomy, childbearing may not be impaired. aEuro cent Data are insufficient to definitively recommend UAE as comparable to myomectomy. aEuro cent Further randomized trials comparing fertility after UAE or myomectomy are warranted.