Fertility After Uterine Artery Embolization: Clinical Takeaways for Procedure Selection and Counseling
A recent analysis reports fertility and pregnancy outcomes after uterine artery embolization and addresses fertility counseling and procedure selection for interventional radiologists and gynecologists.
In that cohort, the authors report a measurable pregnancy rate after UAE and define 'pregnancy' by clinical confirmation rather than biochemical detection; the cohort also includes reported live births and miscarriages, with outcomes censored at the authors' stated follow-up interval. Specifically, the paper provides counts for pregnancies, live births, miscarriages, and ongoing pregnancies at last contact so clinicians can derive cohort live-birth proportions from the provided numerators and denominators. Notably, the follow-up interval used to censor outcomes is the authors' chosen interval and therefore affects cumulative pregnancy and live-birth estimates.
Clinically, observed obstetric complications include preterm birth and postpartum hemorrhage, with absolute event counts presented but small. Demographically, the cohort's age distribution, prior infertility history, and prior myomectomy rates are reported and should be compared with local practice populations when judging applicability. The authors ascertained outcomes via chart review and patient contact and acknowledge loss to follow-up, selection bias, and confounding by prior fertility history, which limit comparative inferences versus myomectomy.
For counseling,
- Offer the cohort's reported pregnancy and live-birth metrics as a benchmark to patients, and frame numeric estimates alongside uncertainty from selection and follow-up limitations.
- For procedural selection, prefer myomectomy when established desire for future fertility or compromised ovarian reserve exists, and offer UAE to patients prioritizing a minimally invasive, uterine-sparing approach when counseling explicitly includes potential trade-offs in fertility certainty.
- For systems, document fertility counseling consistently, refer to fertility specialists when appropriate, and implement active follow-up or registry tracking to improve outcome ascertainment and inform future counseling.