10 THINGS YOU SHOULD KNOW ABOUT UFE PART 2

6. I know that I have many fibroids. Can fibroid embolization treat every single fibroid?

The entire uterus is embolized. Therefore all fibroids must be treated. Many women have asked why the uterus is not affected as well. The reason why UFE treats fibroids and does not affect the uterus is because there is extra blood or collateral flow from other vessels to normal uterine tissue, which allows the doctor to selectively treat fibroids while maintaining viability of the uterus.

 

7. Will I stop having my period after UFE?

A common reason women have UFE is excessive bleeding during their menstrual cycle. The goal is to get your periods back to the way they were before the severe bleeding. Most women will menstruate after the procedure, and it will be pretty close to when they expect it. Any stress for women can make the menstrual cycle a bit off, including the uterine fibroid embolization procedure.

It may take a few months after embolization for a woman's cycle to regulate. There is a small chance, less than 10%, that women over the age of 40 will enter early menopause after the procedure, causing them to stop menstruation permanently.

 

8. I want to get pregnant. Is UFE the right treatment for me?

It is possible for women to become pregnant after the procedure. But it is controversial whether uterine fibroid embolization is the right treatment for women who want a pregnancy.

Traditionally, myomectomy, or surgical removal of fibroids, has been the treatment of choice. Currently  research are supporting myomectomy in women who have symptomatic fibroids and a strong desire to have children. There are randomized trials suggesting that uterine fibroid embolization is comparable to myomectomy for women desiring future fertility with further study in the future.

 

Initially UFE was only performed on women who were not interested in future fertility. These women were studied and some became pregnant and did very well. Doctors realized that it is possible to conceive a healthy child. Over time, emobolization was also offered to women who did not want to completely eliminate future fertility, as they would with a hysterectomy, but wanted a less invasive procedure that has a high probability of eradicating fibroid-related symptoms. It also depends on each woman.

 

9. Do I have to use contraceptives after UFE?

A woman who has her cycle can get pregnant. If she wants to avoid pregnancy, then some contraception must be used, for example, condoms, an IUD, or birth control pills. Once a period returns and is regular, it means a woman is ovulating and can get pregnant, therefore some form of birth control is necessary if she wants to avoid it.

 

10. Is it necessary to do an MRI after uterine fibroid embolization?

Many women will ask if an ultrasound will be enough, but an MRI provides crucial information, before and after the procedure. An ultrasound shows the presence of masses, so you can see where the fibroids are, but cannot tell if the treatment was successful or not. It also cannot be known if a woman has another condition with fibroid-like symptoms called adenomyosis.

With an MRI, doctors can get that information before the procedure to see if a woman is even a candidate for the procedure. The 6-month follow-up MRI can show whether all the fibroids have been treated and the extent of shrinkage.

If a woman has symptoms after embolization and follow-up MRI shows viable fibroids, a repeat procedure may be helpful. On the other hand, if there are no viable fibroids on follow-up MRI, I can advise a woman that her symptoms are probably not due to fibroids and that repeat embolization will not be helpful.