Surgery or UFE: Differences in Fertility & Quality of Life

When choosing fibroid treatments, your two main choices will be surgery or UFE. Fibroid tumors are non-cancerous growths that develop in and on a woman's uterus. While not a life threatening condition, because of their location, they can cause many negative symptoms, including problems with fertility, menstruation, and your bowel and bladder function.

Some women have a higher risk for developing fibroids. While we don't know why these tumors form, we do know that certain factors are connected. That means if you have a family history, or are an African American women, you are more likely to develop fibroids in the future.

If your fibroid risk is high, now's the time to think about your fertility. Women with fibroids who want to have children are often pushed into surgery treatment. Previously, we thought myomectomy, surgical fibroid removal, was a woman's best option if she wanted to get pregnant. Now, research suggests that isn't the case.

Quality of Life with Fibroid Treatments

There's a new FEMME study, published in the New England Journal of Medicine, comparing myomectomy and UFE outcomes. Specifically, the study examines how each fibroid treatment affects your post-procedure quality of life. And the outcomes were very interesting.

After treating fibroids with surgery or UFE, each group of women rated their quality of life. Both groups of women reported significant improvements. And there was only an eight point difference between the two groups' reported improvements. That difference is small enough to be considered statistically insignificant. Or, to put it simply, myomectomy and UFE provides almost identical improvements in your daily life. But their post-treatment recovery process is different: UFE has almost no down time. While myomectomy is still an invasive surgery, which may require a hospital stay.

Given these differences, the FEMME study should offer proof that you should explore UFE if you're considering myomectomy. Since the two fibroid treatments offer similar benefits, and UFE comes with an easier recovery. Now, it's important to remember that the FEMME study didn't address fertility outcomes with either of these fibroid treatment options. So we'll turn to that data in the next sections of this post.

Myomectomies Don't Improve Fertility

Check this out. A study examining "the effect of myomectomy on fertility[discovered] no significant benefit," according to a review in the Cochrane journal. In other words, even if you have surgery to remove your fibroid tumors, your chances of getting or staying pregnant may not improve.

Of course, this is just one study. We need more research to really prove the effect of fibroid surgery on fertility. It does, however, mean that women should carefully consider all their treatment options before rushing into surgery just to preserve their fertility dreams.

UFE and Pregnancy

Patients with fibroids  who hope to get pregnant may also consider uterine fibroid embolization, a minimally invasive procedure that effectively kills fibroids by cutting off their blood supply. Many patients wishing to avoid myomectomy want to know if they can become pregnant after uterine fibroid embolization. There have been reports of many successful pregnancies in patients after UFE. Many studies show that fertility rates and miscarriage rates in UFE patients are no different than patients of the same age with fibroids who have had no treatment. But, if you are willing to have surgery, and you're healthy enough for a myomectomy, discuss the advantages with your provider.

Early studies suggested a slight increase in pregnancy complications after UFE vs myomectomy. But newer science suggests that tweaks to the UFE process improved fertility and pregnancy outcomes. These pregnancy complications can include pre-term labor and pregnancy induced hypertension, also known as pre eclampsia. UFE can still help patients who aren't good candidates for surgery. All this will be especially true if it turns out that myomectomy really can't improve your fertility.

Sources: New England Journal of Medicine, Canadian Family Physician journal, European Radiology Journal