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Pregnancy and Uterine Fibroid Disease (Part 2)      

By:  Hope Waltman

Robert Worthington-Kirsch, M.D., FSCVIR, regularly performs both vascular and non-vascular procedures for the management of a wide variety of medical conditions at Roxborough Memorial Hospital, Philadelphia, Pennsylvania, since 1990.  His particular areas of interest include Gynecological Interventional Radiology, Biliary Interventional Radiology, and Venous Access.  Dr. Kirsch was the second physician in the United States to begin performing Uterine Artery Embolization (UAE) treatment for uterine fibroids in the second half of 1996.

Dr. Kirsch continues to travel extensively throughout the United States as well as the world (Canada, France, England, Brazil, and Sweden) giving lectures and training UAE to gynecology and radiology physicians. 

He is involved in both independent and industry-sponsored research studies about UAE.  The following are questions answered by Dr. Worthington-Kirsch:  

Have any of the women you performed the Uterine Artery Embolization procedure on become pregnant?   

There are many women who have become pregnant after having UAE.  I have had at least a dozen of my patients conceive after the procedure.  Their pregnancy outcomes have been similar to those of women the same age in the general population. 

At this time there is little published or presented data about fertility after UAE. The data does suggest that fertility after UAE is similar to that of women who have had other invasive treatments for fibroids. The decision about fibroid treatments in women who want to preserve their fertility is very complex, and needs the input of the patient, a skilled IR, and an experienced Ob/Gyn or Reproductive Endocrinologist (fertility specialist).

How long should a UAE patient wait before trying to conceive? 

There really isn’t a good guideline for a waiting period.  Nobody knows whether, or how long, a woman should wait after UAE before attempting to become pregnant. 

I'm aware of two women who became pregnant within a month of their embolizations, and both had normal pregnancies and delivered healthy babies.   In general, I suggest that women wait four to six weeks after UAE before attempting to become pregnant. 

How do you keep the entire uterine artery from being clogged? 

This depends on the degree to which the artery is embolized and the material chosen for the embolization. It’s largely a matter of skill and experience with the embolization procedure. 

Can the ovarian artery be clogged by the particles? 

This can happen, but appears to be quite rare. Even if a few particles get into the ovary, they do not necessarily damage the function of the ovary itself. Some women, most of them over the age of 45, will have menstrual irregularities or stop having periods after UAE. The majority of women have no interruption in their menstrual periods after UAE.

Overall, the risk of significant complications is higher with hysterectomy and myomectomy than it is with UAE.

Will new blood vessels grow to supply the uterine fibroids? 

This has not been observed.  If the uterine fibroids are destroyed, new blood vessels will not grow into them.   (Refer to Part 1.)

Hope For Fibroids Organization, www.hopeforfibroids.org, Hope Waltman, Founder, (e-mail) hopewaltman@paonline.com.  Dr. Kirsch is the Medical Advisor for this web site.

For more information on uterine fibroid treatments refer to www.fibroidcorner.com or contact Robert L. Worthington-Kirsch, MD, FSCVIR,  e-mail kirsch@igsapc.com.

Updated version:  April 22, 2003

Copyright:  Today's Woman October 2002 Issue, Lancaster, Pennsylvania
 

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