Uterine artery embolization (UAE) is a relatively new fibroid treatment: the procedure has only been widely used since 1996. Between 1996 and 2002, as many as 30,000 uterine artery embolization procedures have been performed. The procedure is popular because it offers an 85 percent success rate with very low chance of complications.

An interventional radiologist performs the UAE. A small incision is made in the groin, and a catheter is inserted into the femoral artery. Iodine, or another radiographic dye, is injected into the blood stream, which allows the blood vessels to show up on an x-ray called an angiogram. The doctor uses the angiogram as a "road map" to guide the catheter to the fibroid's blood vessels. Once the catheter is in position, particles of plastic or gelatin are passed through it and into the fibroid blood vessels.

 

The particles, each approximately the size of a grain of sand, block the flow of blood to the fibroid tissue. The fibroid begins to shrink due to lack of blood. Treatment results vary, but on average, fibroid size is reduced between twenty to seventy percent over the six months following the procedure.

Complications from uterine artery embolization occur in three to five percent of cases. Pain and cramping may occur after the procedure, but these symptoms usually fade within a few days. Nausea and fever may also occur, and can be treated with medication. If pain, nausea, or fever persists, seek medical attention—it could be a sign of infection.

 

In less than one percent of patients, UAE results in injuries to the uterus. This can be serious, and a hysterectomy may be required. A few women may enter menopause after UAE; research has yet to determine exactly why this occurs. Only rarely are complications life threatening.

Information concerning uterine artery embolization and fertility is sketchy. Most women who undergo UAE procedures are approaching menopause, and not planning a future pregnancy. A number of small studies have been done. Some claim that the chance of miscarriage and premature labor increases, or that infertility may occur if the ovarian blood supply is accidentally blocked. However, these studies are of limited scope. Larger, long-term trials are required to determine the effect of UAE on pregnancy.

 

 

Concerned About Radiation Levels? UAE requires the use of x-rays to guide the catheter, so radiation levels are a concern to many women, especially if they plan to have children after the procedure. The level of radiation used during uterine artery embolization is not considered to be detrimental to health or fertility.

 

 

What is known, is that some women who have had UAE have become pregnant, and carried their babies to term. Comparative studies between UAE and myomectomy should provide more information. Such studies will reveal whether the safety and benefits of uterine artery embolization are comparable to myomectomy.