Pregnancy after Myomectomy vs Pregnancy after UFE

Fertility and pregnancy-related questions are at the top of the list when a woman of childbearing age is diagnosed with uterine fibroids. “Will I be able to have kids? How can fibroids affect my pregnancy and fertility? Will I need a C-section? Am I at risk of a miscarriage? And the list goes on.

To begin with, let’s talk about the manner in which fibroids can affect your fertility. According to the Fertility Institute, where a fibroid is located and its size can determine whether it will affect your fertility. If a fibroid is inside the uterine cavity or is over 6 cm, then it may reduce the chances of conception by up to 70%. Fibroids can have the following effects on fertility:

  • Fibroids in the uterus can distort the cervix, reducing the number of viable sperm that can pass through.
  • The uterus’s shape can be altered by fibroids, interfering with the movement of the sperm or embryo.
  • Fibroids can block fallopian tubes.
  • Fibroid tumors can affect the size of the lining of the uterine cavity.
  • Uterine fibroids can affect the amount of blood flow to the uterine cavity, decreasing the ability of an embryo to implant itself into the uterine wall or develop.
  • Fibroids can interrupt or prevent pregnancy from reaching full term.

⇒ Related: Pregnancy with Uterine Fibroids

Unfortunately, between 20 and 50 percent of women of childbearing age have fibroids, but the good news is that they do not have to live with them. There are options.

Understand Your Options after Fibroid Treatment

To learn more about what to expect after myomectomy and UFE, watch the full video “Fibroids and Pregnancy: Understand Your Options”. In this video, Dr. John Lipman of Atlanta Fibroid Center answers the following questions and more about fertility after a myomectomy vs. UFE and pregnancy:

  1. Should I worry if I am diagnosed with fibroids while pregnant?
  2. Is a C-section required after myomectomy or UFE?
  3. Can I have a full-term birth after myomectomy or UFE?
  4. Should I expect a more difficult pregnancy after UFE?
  5. Is it safe to breastfeed after UFE?

A Myomectomy May Turn Into A Hysterectomy

Women who have myomectomy surgery may run the risk of waking up without their uterus. Dr. Lipman explains in this video that women must sign a consent form before their surgery, acknowledging that they understand that a hysterectomy may be performed instead of a myomectomy if the surgeon feels it is medically necessary. While the percentage of this occurring is only 3-4%, it will make a difference to three or four women out of 100 who undergo a myomectomy this year.

When comparing myomectomy vs. UFE and pregnancy potential, you may be surprised to find out that research shows that the statistics are fairly close. A study of almost 200 women showed that about half of them became pregnant after undergoing a myomectomy; however, the odds went down depending on factors such as their age (the odds declined for women over 35) and how many incisions were made in their uterus (each incision reduced the odds incrementally). It is important to note that 33% of all women have fertility issues, and between 5% and 10% are related to fibroids.

Fertility and Uterine Fibroid Embolization (UFE)

Having a healthy pregnancy and delivery are both possible after uterine fibroid embolization (UFE).

Most treatments that are used for uterine fibroids are unable to effectively treat and eliminate all of the fibroids present and therefore only work for a handful of women. UFE can treat all fibroids, even if they are located deep within the uterine wall.

Dr. T. Bilhim, located in Lisbon, Portugal, is an interventional radiologist who participated in a fertility study of over 350 women whose fibroids were eliminated using the UFE procedure. None of these women had been successful in conceiving before they had UFE, but almost half of them successfully became pregnant afterward.

Bilhim explained that this study had significant meaning to the radiology community because it debunks the misconception that UFE is not a viable option for women who desire to preserve their fertility. While this was not news to Dr. Lipman, an interventional radiologist here at the Atlanta Fibroid Center who has witnessed countless successful pregnancies and full-term babies from his previous patients, it was a much-needed breakthrough to help quell the misinformation that is still circulating. Evidence from this study demonstrates that UFE is safe for future fertility and may even help some people regain their fertility.

Related Video: The Miracle Baby of Doris Combs

Doris Combs had a UFE in 1997; her son, Jalen Comb Jackson, was born in 2001. Read the full article “Fibroids And Pregnancy”.

A recent study published in the International Journal of Biomedicine showed that the frequency of pregnancy and delivery complications among women who have had UFE for fibroid treatment isn’t significantly different from women who are unaffected by fibroids. What’s more, these complication rates were much lower in comparison to women with fibroids who haven’t had UFE but were treated with either medical therapy or had no other treatment at all.

Making a Decision That Is Best for You

At the end of the day, it’s important to choose a treatment option that is right for you. It’s important to research and understand all the pros and cons of each procedure and discuss your unique situation with experienced doctors (yes, in plural!). Due to the fact that myomectomy is usually performed by an OB/GYN and UFE is performed by an experienced interventional radiologist, you should seek expert advice from both specialists to fully understand how these two different treatments may affect your fertility.

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