Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis.
OBJECTIVE
To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.


METHODS
Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 mum.


RESULTS
Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.


CONCLUSIONS
Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure.
Kim
Man Deuk
MD
Department of Diagnostic Radiology, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do 463-712, Republic of Korea. mdkim@cha.ac.kr
Kim
Nahk Keun
NK
Kim
Hee Jin
HJ
Lee
Mee Hwa
MH
D000328:Adult; D001158:Arteries / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005306:Fertilization; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008429:Maternal Welfare; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011859:Radiography; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000628:therapy; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*
D003287:Contrast Media; D011142:Polyvinyl Alcohol