Abstract

Uterine artery fibroid embolisation has now been used in the management of women with fibroids for over two decades. This review summarises the evidence on the efficacy of the procedure in the management of menstrual symptoms and the reproductive outcomes in women who have undergone embolisation. The reported literature suggests it to be an effective alternative to hysterectomy and myomectomy in the management of women with symptomatic fibroids with significant improvement in menstrual loss and reduction in fibroid size. The evidence on the reproductive outcomes following the procedure is less robust and is largely from non-randomised cohort studies and one randomised trial that assessed this as a primary outcome. These suggest a less favourable reproductive outcome compared to women undergoing myomectomy with higher miscarriage, Caesarean section and post-partum haemorrhage rates. In conclusion, the literature shows uterine artery fibroid embolisation to be a safe and effective option in women with fibroids. Caution, however, is needed when considering embolisation in women who wish to preserve fertility, and the latter remains a relative contra-indication for the procedure.

Keywords: Uterine artery fibroid embolisation, fibroids, fertility, menstrual symptoms, hysterectomy, myomectomy, menstrual loss, miscarriage, post-partum haemorrhage, Uterine fibroids, menorrhagia, dysmenorrhoea, fibroid embolisation, post-procedure FSH, Obstetricians, Gynaecologists, pulmonary embolus, venous thromboembolus, hyper vascular fibroids, ntramural fibroids, submucous fibroids, pregnancies, Caesarean hysterectomy), fetal growth restriction, endometrial ischaemia, necrosis, uterine leiomyomas, Transcatheter uterine artery, uterine myomata, sepsis, infertility, intramural fibroids, fibromyomata