Pregnancy after embolization ​ ​

In the early years of embolization, there was a widespread prejudice that embolization would prevent pregnancy and that it was not suitable for women who underwent embolization to become pregnant. Contrary to this belief commonly expressed by some obstetricians, there are tens of thousands of women in the world who became pregnant after embolization and gave birth completely normally. Among our patients also, there are many women who became pregnant and delivered normally after embolization and also even those who gave birth to twins.

 

Therefore, it is now generally believed that embolization therapy does not interfere with conception and healthy delivery. However, there is a small theoretical risk of damage to the ovaries and uterus during the embolization procedure. This risk is especially relevant if very small diameter occlusive particles are used and aggressive embolization is performed. However, this risk is minimal if medium-large particles are used during embolization and the embolization is terminated when the main vessels of the uterus begin to occlude.

 

The risk of damaging the uterus during embolization is also present in other treatment methods; The sutures used during myomectomy may cause infection, adhesions and deformation in the uterus. If the bleeding cannot be stopped, emergency hysterectomy may be required. In HIFU and percutaneous ablation, the heat applied while burning the fibroid can also damage the surrounding tissues and the inner surface of the uterus. As a result, each treatment applied in myomas may affect the possibility of the patient to become pregnant. Studies comparing treatment methods on this subject are few. In a recent study, the rate of getting pregnant after myomectomy surgery and embolization was found to be the similar in patients with fibroids who wanted pregnancy (Pisco et al, Fertil Steril 2010). In another study, it was shown that about half of the patients who wanted pregnancy after embolization became pregnant and gave birth in the normal way and some others became pregnant with assistive techniques. ​ ​

 

In conclusion, pregnancy after embolization is possible. However, women wishing to conceive should undergo a less aggressive embolization with special technique by experienced operators. ​ ​

 

Video: Pregnancy after fibroid embolization, Prof Dr Saim Yılmaz