The impact of uterine fibroid embolization on resumption of menses and ovarian function

PURPOSE: To evaluate the effect of uterine fibroid embolization (UFE) on me nstruation and ovarian function, METHODS: The authors performed an observational study of UFE for the treatm ent of symptomatic fibroids, All patients had regular predictable menses be fore intervention and none had clinical or laboratory findings of menopause . UFE was performed with use of standard methods with 355-700-mu m-diameter polyvinyl alcohol (PVA) foam particles. The incidence of ovarian failure w as calculated for women younger than 45 years and for those 45 years or old er, based on retrospective stratification by age. The authors assessed stat istical differences in ovarian failure between the two age groups with use of the chi(2) test, RESULTS: Sixty-six premenopausal women (age range, 30-55 years) underwent b ilateral UFE and were followed for an average of 21 weeks (range, 12-77 wee ks). In 56 of 66 (85%) patients, regular menses resumed after an average of 3.5 (range, 1-8) weeks. In 10 of 66 (15%) patients, regular menses did not resume. Clinical and biochemical findings consistent with ovarian failure and presumed menopause were seen in nine of 10 patients without resumption of menses (14% of total patients). Ovarian failure occurred in nine of 21 ( 43%) women older than 45 years and in none of the 45 women younger than 45 years (P < .05), There were no differences in presenting symptoms, amount o f PVA used, or fibroid size between patients who did and did not resume men ses. CONCLUSION: The majority of patients undergoing UFE will have resumption of menses, but the incidence of postprocedure ovarian failure is considerably higher than reported to date. Loss of menses induced by UFE is significant ly more likely to occur in women older than 45 years.