title: Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors.
abstract: OBJECTIVE
  To evaluate the fertility of women eligible for surgical multiple myomectomy, but who carefully elected a fertility-sparing uterine artery embolization (UAE).
  
  
  METHODS
  Non-comparative open-label trial, on women ≤40 years, presenting with multiple symptomatic fibroids (at least 3, ≥3 cm), immediate pregnancy wish, and no associated infertility factor. Women had a bilateral limited UAE using tris-acryl gelatin microspheres ≥500 μm. Fertility, ovarian reserve, uterus and fibroid sizes, and quality of life questionnaires (UFS-QoL) were prospectively followed.
  
  
  RESULTS
  Fifteen patients, aged 34.8 years (95%CI 32.2-37.5, median 36.0, q1-q3 29.4-39.5) were included from November 2008 to May 2012. During the year following UAE, 9 women actively attempting to conceive experienced 5 live-births (intention-to-treat fertility rate 33.3%, 95%CI 11.8%-61.6%). Markers of ovarian reserve remained stable. The symptoms score was reduced by 66% (95%CI 48%-85%) and the quality of life score was improved by 112% (95%CI 21%-204%). Uterine volume was reduced by 38% (95%CI 24%-52%). Women were followed for 43.1 months (95%CI 32.4-53.9), 10 live-births occurred in 8 patients, and 5 patients required secondary surgeries for fibroids.
  
  
  CONCLUSIONS
  Women without associated infertility factors demonstrated an encouraging capacity to deliver after UAE. Further randomized controlled trials comparing UAE and myomectomy are warranted.
  
  
  CONCLUSIONS
  • Women without infertility factors showed an encouraging delivery rate after UAE. • For women choosing UAE over abdominal myomectomy, childbearing may not be impaired. • Data are insufficient to definitively recommend UAE as comparable to myomectomy. • Further randomized trials comparing fertility after UAE or myomectomy are warranted.
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France.|Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Torre
authors.affiliation: Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France. afauconnier@chi-poissy-st-germain.fr.|EA7285, Risques cliniques et sécurité en santé des femmes et en santé périnatale, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France. afauconnier@chi-poissy-st-germain.fr.|Department of Obstetric Gynecology, Poissy-Saint Germain Hospital, 10 rue du Champ Gaillard, F-78303, Poissy, France. afauconnier@chi-poissy-st-germain.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fauconnier
authors.affiliation: Service de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, 46 Rue Henri Huchard, 75018, Paris, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Kahn
authors.affiliation: Service de Radiologie, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Limot
authors.affiliation: URC Paris Descartes Necker Cochin, 149 Rue de Sèvres, 75015, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bussierres
authors.affiliation: Service de Radiologie, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Pelage
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D018230:Leiomyoma, Epithelioid / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000009:adverse effects*; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
keywords: Clinical trial; Fertility; Leiomyoma; Symptoms; Uterine artery embolization