title: Is myomectomy always the best choice for infertile women with symptomatic uterine fibroids?
abstract: Uterine artery embolization (UAE) is still regarded by most gynaecologists as contraindicated for women with symptomatic fibroids and otherwise unexplained infertility. For such patients, myomectomy is the usual option. We performed UAE as treatment of menorrhagia in an infertile woman with multiple subserosal and intramural fibroids who had previously failed multiple myomectomy. UAE resulted in durable symptom relief and substantial reduction of the uterine and fibroid size. The patient conceived spontaneously 20 months after UAE and progressed through pregnancy uneventfully. At 38 weeks of gestation, she underwent elective cesarean section and delivered a normal, healthy, 3180-g fetus without complications. The present case demonstrates that in symptomatic women with multiple subserosal and intramural fibroids and otherwise unexplained infertility, UAE may have symptomatic and reproductive outcomes superior to those of myomectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy. giovanna.tropeano@rm.unicatt.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tropeano
authors.forename: Domenico
authors.initials: D
authors.lastname: Romano
authors.forename: Floriana
authors.initials: F
authors.lastname: Mascilini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Gaglione
authors.forename: Sonia
authors.initials: S
authors.lastname: Amoroso
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007889:Leiomyoma / Q000601:surgery* / Q000628:therapy; D011247:Pregnancy; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000601:surgery* / Q000628:therapy