Pregnancy and embolization
As a general rule embolization is not recommended for women who want to get pregnant.
It is best for women who have completed their families and are looking for a non-surgical alternative to treat their fibroids.
Women who want to be pregnant after fibroid treatment should probably opt for a surgical procedure rather than embolization, as though it can be used in
women who are looking to get pregnant, the main drawback is the possibility of going into premature menopause which can happen in about 1-2% of women aged 40 years and under, and as many as 5% in women over the age of 45 years, reaching up to 15% by the age of 50years
Pregnancy after embolization can also be associated with:
Increased risk of miscarriage
Increased risk of bleeding after delivery
Increased risk of caesarean section
Increased risk of baby being in the wrong position
For these reason myomectomy remains a sensible option for women who want to get pregnant and if possible laparoscopic myomectomy is the best option.
Is the procedure effective?
Yes in a recent report by NICE (National Institute of Clinical Excellence) in 2010, they reported on a registry of 1387 women and found that symptoms related to fibroids were improved by 84% at 6 months and 83% at 24 months, with significant improvement in quality of life.
It can be expected that the fibroids will decrease in size by 40%
Is it as effective as myomectomy?
In relation to pregnancy it is not. A recent medical study that looked into this thought it was not superior to myomectomy they looked at 121 women treated with embolization they had a pregnancy rate of 50% compared to 78% in the myomectomy group.
Miscarriage rate was also more in the embolization group 64% compared to 23%
Looking at resolution of symptoms surgery is also superior to embolization at 1month and 12 months follow up
What are the down sides of having an embolization?
In one study up to 23% of women needed another intervention to control their symptoms either hysterectomy or repeat embolization another reported the rate to be 28% at 5 year follow up.
The chance of re-intervention increases the younger you are when you have the procedure.
Is it suitable for women who have had a failed surgical procedure for fibroids?
Yes it may be suitable but again for women who have completed their family.
Unfortunately there have been recent reports that it is more likely to fail in women who have had a previous myomectomy. However for this group of women it is a matter of weighing up risks and benefits. Usually if women have had a previous myomectomy particularly an “open” procedure, there is a 90% chance that there will be adhesions (scar tissue) in the abdomen. Of these adhesions 30% may be significant and increase the risk of complications for a repeat operation. Therefore for some women embolization may be a safer option.
Again this should be weighed up against the benefits of a repeat procedure for fibroids. In women who have had a previous open operation for fibroids the results for control of symptoms are not as good neither are fertility rates.
The likelihood of fibroid regrowth is 20-25% over 5 years.
As a general rule embolization is not recommended for women who want to get pregnant.
It is best for women who have completed their families and are looking for a non-surgical alternative to treat their fibroids.
Women who want to be pregnant after fibroid treatment should probably opt for a surgical procedure rather than embolization, as though it can be used in
women who are looking to get pregnant, the main drawback is the possibility of going into premature menopause which can happen in about 1-2% of women aged 40 years and under, and as many as 5% in women over the age of 45 years, reaching up to 15% by the age of 50years
Pregnancy after embolization can also be associated with:
Increased risk of miscarriage
Increased risk of bleeding after delivery
Increased risk of caesarean section
Increased risk of baby being in the wrong position
For these reason myomectomy remains a sensible option for women who want to get pregnant and if possible laparoscopic myomectomy is the best option.
Is the procedure effective?
Yes in a recent report by NICE (National Institute of Clinical Excellence) in 2010, they reported on a registry of 1387 women and found that symptoms related to fibroids were improved by 84% at 6 months and 83% at 24 months, with significant improvement in quality of life.
It can be expected that the fibroids will decrease in size by 40%
Is it as effective as myomectomy?
In relation to pregnancy it is not. A recent medical study that looked into this thought it was not superior to myomectomy they looked at 121 women treated with embolization they had a pregnancy rate of 50% compared to 78% in the myomectomy group.
Miscarriage rate was also more in the embolization group 64% compared to 23%
Looking at resolution of symptoms surgery is also superior to embolization at 1month and 12 months follow up
What are the down sides of having an embolization?
In one study up to 23% of women needed another intervention to control their symptoms either hysterectomy or repeat embolization another reported the rate to be 28% at 5 year follow up.
The chance of re-intervention increases the younger you are when you have the procedure.
Is it suitable for women who have had a failed surgical procedure for fibroids?
Yes it may be suitable but again for women who have completed their family.
Unfortunately there have been recent reports that it is more likely to fail in women who have had a previous myomectomy. However for this group of women it is a matter of weighing up risks and benefits. Usually if women have had a previous myomectomy particularly an “open” procedure, there is a 90% chance that there will be adhesions (scar tissue) in the abdomen. Of these adhesions 30% may be significant and increase the risk of complications for a repeat operation. Therefore for some women embolization may be a safer option.
Again this should be weighed up against the benefits of a repeat procedure for fibroids. In women who have had a previous open operation for fibroids the results for control of symptoms are not as good neither are fertility rates.
The likelihood of fibroid regrowth is 20-25% over 5 years.
RSS Feed