Uterine fibroids- benign tumors that grow on the wall of the uterus –are one of the most common causes behind infertility and pregnancy complications.
The standard treatment is to have the fibroids removed from the uterine wall through a surgery called a myomectomy, which involves cutting through the skin on the lower abdomen to get to the uterus. This invasive procedure isn’t always effective and can come with a series of complications: excessive blood loss, build up of scar tissue and in some cases, further complications to childbirth. Rarely, surgeons have to perform a hysterectomy, the removal of part of or all of the uterus because the bleeding is uncontrollable or other abnormalities are present.
But in a recent study conducted at the New University of Lisbon, research suggests that a minimally invasive procedure known as uterine fibroid embolization may allow for people with uterine fibroids to have a more normal pregnancy.
Uterine fibroid embolization involves destroying fibroids by blocking the arteries supplying them with blood. The procedure uses a form of real-time x-ray called fluoroscopy to guide the delivery of embolic agents to the uterus and fibroids. But some doctors have avoided suggesting this option to women looking to conceive as the procedure as it may restrict blood flow to the lining of the uterus and ovaries.
“The doctor passes a catheter, or very small tube, through a small incision in your groin into the blood supply to the fibroid,” says Wulf H. Utian, MD, PhD an independent consultant in women’s health issues in a post on Healthy Women. “Then the doctor injects tiny plastic or gelatin sponge particles, about the size of a grain of sand, through the catheter into the artery. The particles stop blood flow to the fibroid and over time, the fibroid shrinks.”
But some doctors have avoided suggesting this option to women looking to conceive as the procedure may restrict blood flow to the lining of the uterus and ovaries.
“Uterine embolization procedure is a controversial matter because it is still seen as a risk to fertility,” said lead author of the study Joao Martins Pisco in an interview with Reuters. “With this study we were able to verify that women who could not conceive due to uterine fibroids, once subjected to embolization, could have a normal pregnancy with a live newborn.”
For nearly six years, researchers followed 359 women after they underwent a uterine fibroid embolization. 42% of the participants became pregnant at least once during those six years and 131 women had a collective total of 150 live births. By the end of the study, 79% of women had experienced improvements to fibroid-related symptoms, including pelvic pain and pressure, abnormal menstrual bleeding and urinary problems. In 28 cases, participants needed further embolization procedures because the fibroids weren’t fully treated during the initial procedure.