Interventional Radiology — UAE vs Future Fertility

Key Takeaways

• UAE offers a minimally invasive treatment for fibroids but may compromise future fertility in certain patients.
• Myomectomy often remains the gold standard for women planning pregnancy.
• Interventional radiology innovations are reducing risks, but careful patient selection is essential.
• In some cases, UAE can preserve fertility when surgery is not an option.
• Consultation with both an interventional radiologist and a reproductive specialist ensures informed decision-making.

Interventional radiology has transformed women’s health, offering minimally invasive procedures for conditions like fibroids, adenomyosis, and pelvic vascular issues. Uterine Artery Embolization (UAE) is one of the most widely used alternatives to surgery — providing quick recovery and excellent symptom relief.

However, a key question remains:

Does UAE affect future fertility?

For women planning pregnancy, understanding the balance between symptom relief and long-term reproductive health is essential. This blog explores UAE, compares it to surgical options, examines fertility outcomes, and provides guidance for patients preparing for future conception or assisted reproduction.

What Is Interventional Radiology in Women’s Health?

Interventional radiology uses imaging (X-ray, CT, MRI, ultrasound) to guide minimally invasive procedures that treat fibroids, bleeding disorders, or vascular abnormalities without major surgery.

Common IR Procedures for Gynecologic Health

• Uterine Artery Embolization (UAE)
• Pelvic vein embolization
• Ovarian cyst drainage
• Image-guided biopsies

Among these, UAE has the most direct fertility implications.

What Is Uterine Artery Embolization (UAE)?

UAE blocks blood flow to fibroids by injecting tiny particles into the uterine arteries.
It results in fibroid shrinkage, reduced bleeding, and fast symptom improvement.

Benefits of UAE

• Minimally invasive
• 1–2 day recovery
• No large incisions
• Effective for heavy bleeding & bulk symptoms

But fertility impact is complex.

How Does UAE Affect Fertility?

Impact on Ovarian Reserve

Some women experience:

• Reduced AMH
• Potential menopausal symptoms in high-risk patients
• Compromised ovarian blood flow (rare but possible)

Older women (>40) are more susceptible.

Impact on Uterine Lining

UAE may lead to:

• Endometrial thinning
• Reduced blood supply
• Higher miscarriage risk
• Placental abnormalities in pregnancy

Pregnancy Rates After UAE

Studies show:

• Lower pregnancy rates compared to myomectomy
• Higher miscarriage risk
• Increased risk of preterm delivery
• Placental complications

This is why myomectomy is preferred for women who want biological children.

UAE vs Myomectomy — Which Is Better for Fertility?

Bottom Line:

If fertility is a priority, myomectomy remains the gold standard.

When UAE Can Be a Reasonable Choice

• When a patient is not medically fit for surgery
• When fibroids are numerous or in difficult locations
• When immediate symptom control is needed
• When a woman is nearing menopause
• When surgery carries high risk due to underlying conditions

In selected cases, UAE can preserve fertility better than leaving fibroids untreated.

Improving Future Fertility After UAE

1. Pre-procedure evaluation

• AMH
• Ultrasound
• Ovarian reserve testing
• Specialist fertility consultation

2. Post-procedure monitoring

• Repeat imaging
• Lining assessment
• Hormonal support (if required)

3. Consider IVF Timing

Many specialists recommend waiting 6–12 months after UAE before trying to conceive or pursuing IVF.

4. Lifestyle & Healing

• Anti-inflammatory diet
• Iron support
• Hormonal balancing
• Regular monitoring

Case Study

Patient: Neha, 35
Condition: Multiple large fibroids
Plan: UAE recommended due to high surgical risk

Outcome:
Fibroids shrank by 60%, symptoms resolved, and fertility markers remained stable. After 8 months, Neha pursued IVF and conceived successfully.

Key Insight:
When surgery is risky, UAE may be the safer fertility-preserving alternative.

Testimonials

“UAE helped shrink my fibroids without surgery. My cycles normalized, and I felt hopeful again.” — Priya B.

“I was scared that my fertility would be affected, but with careful planning and follow-up, I conceived naturally after UAE.” — Aditi R.

“The procedure was quick and painless. Getting both IR and fertility opinions helped me make the best decision.” — Shalini P.

Expert Quote

“UAE remains a valuable tool, but fertility planning requires individualized decision-making. A thorough evaluation with both an interventional radiologist and reproductive endocrinologist ensures that women make informed, empowered choices.”
— Dr. Arjun Mehta, Reproductive Endocrinologist

Related Links

• Fibroids & Fertility Hub
• Uterine Health
• Surgical Options for Fibroids
• Fertility After Hysteroscopy
• FET & IVF Pathways

Glossary

• UAE (Uterine Artery Embolization): A minimally invasive procedure to block blood supply to fibroids.
• Interventional Radiology: Image-guided procedures performed through tiny incisions.
• Fibroids: Noncancerous growths in the uterus.
• Myomectomy: Surgical removal of fibroids, preferred for fertility.
• Ovarian Reserve: A measure of egg supply.
• Endometrium: Inner lining of the uterus.
• Embolization Material: Tiny particles used to block blood vessels.

FAQs

Q. Is UAE safe for women who want to conceive?

Ans : UAE can be safe for some women, but fertility outcomes are generally lower compared to myomectomy. Risks include reduced ovarian reserve and uterine lining changes. A fertility specialist should evaluate your specific condition.

Q. How soon after UAE can I try to get pregnant?

Ans : Most providers recommend waiting 6–12 months to allow full healing, improved blood flow, and stabilization of the uterine lining.

Q. Can UAE cause early menopause?

Ans : Yes, although rare. Women over 40 or with low ovarian reserve are at higher risk of diminished ovarian function after UAE.

Q. What are the main fertility risks after UAE?

• Thin endometrium
• Reduced ovarian reserve
• Higher miscarriage rate
• Placental abnormalities
• Preterm birth risk

Q. Is myomectomy better for future fertility?

Ans : Yes. Myomectomy remains the gold standard for women planning pregnancy, offering better fertility rates and lower pregnancy complications.

Q. Does UAE affect IVF success rates?

Ans : It can. IVF success may be lower if lining thickness or uterine blood flow is compromised. Patients should be monitored closely post-UAE.

Q. Can UAE be repeated if symptoms return?

Ans : Yes, UAE can be repeated in some patients. However, recurrence depends on fibroid size, type, and vascular patterns.

Q. What if I’m not a candidate for surgery?

Ans : UAE becomes an excellent option when myomectomy is medically unsafe due to anemia, comorbidities, or fibroid complexity.

Q. Are pregnancies after UAE high-risk?

Ans : Yes. Pregnancies after UAE require high-risk monitoring due to possible:

• Placenta previa
• Placenta accreta
• Growth restriction
• Preterm labor

Q. Do all fibroids shrink after UAE?

Ans : Most shrink by 30–60%, but results vary depending on fibroid type, vascularity, and size.

Q. Can UAE cause adhesions?

Ans : It usually doesn’t cause adhesions, unlike surgery, making it beneficial for certain patients who wish to avoid scarring-related fertility risks.

Q. Should I freeze eggs before UAE?

Ans : If you have low ovarian reserve, are above 35, or have complex fertility needs, egg or embryo freezing may be recommended before UAE.

Understanding your treatment options is the first step toward preserving your fertility.
Explore expert resources and book guided consultations at www.surrogacy.com.