THE COMPLETE GUIDE TO UTERINE FIBROID EMBOLIZATION (UFE)

UFE is a minimally invasive procedure that shrinks fibroids by blocking their blood supply. A thin catheter is inserted through a tiny puncture in the wrist or groin and guided to the uterine arteries using real-time X-ray imaging. Microscopic particles are injected to block blood flow to the fibroids. The procedure takes 60 to 90 minutes under conscious sedation, and most patients go home the next morning. UFE treats all fibroids simultaneously regardless of number or location, preserves the uterus, and achieves 85 to 95 percent symptom improvement.

Most women return to desk work in 7 to 10 days and physically demanding work in 1 to 2 weeks. The first 24 hours involve the most intense cramping, managed with IV pain medication during an overnight hospital stay. Post-embolization syndrome — cramping, low-grade fever, and fatigue — affects about 50 percent of patients during days 1 through 5 and resolves on its own. Compare this to 6 to 8 weeks of recovery after hysterectomy or 2 to 6 weeks after myomectomy.

UFE achieves 85 to 95 percent overall symptom improvement. Heavy bleeding resolves in over 90 percent of patients. Bulk symptoms like pressure and urinary frequency improve in 82 to 92 percent. Fibroid volume shrinks by 42 to 52 percent within six months and continues beyond. At five years, 73 to 80 percent of patients maintain symptom control. The FIBROID Registry of over 3,000 patients reported 85.7 percent of women would recommend UFE at three years.

The first 24 hours involve significant cramping — patients often compare it to intense menstrual cramps or labor pains. This is managed with IV pain medication during your overnight stay. We are honest about this because patients who are prepared cope better than those who are surprised. By days 3 to 5, cramping transitions to a dull ache managed with oral medication. Most women describe the experience as very manageable after the first day, and many say it was easier than they expected. The number one recovery tip from patients: request anti-nausea medication proactively.

UFE preserves the uterus, so pregnancy remains possible. Published pregnancy rates after UFE range from 23 to 41.5 percent. However, myomectomy has better fertility outcomes (48 to 56 percent pregnancy rate) and is recommended as the first-line treatment for women actively planning pregnancy. For women not planning immediate pregnancy but wanting to preserve the option, UFE maintains that possibility while providing excellent symptom relief. The FEMME trial found no significant difference in ovarian reserve between UFE and myomectomy at 12 months.

Yes. UFE is covered by Blue Cross Blue Shield of Alabama (90 percent or more of the local market), TRICARE, Medicare, Medicaid, UnitedHealthcare, Aetna, Cigna, and virtually all major commercial plans. Typical out-of-pocket with insurance is $2,000 to $3,000. Our team verifies your coverage and handles prior authorization.

It depends on your priorities. UFE preserves your uterus with 7–10 day recovery, 1.3–4.8 percent major complication rate, and 85–95 percent symptom resolution. Hysterectomy provides nearly 100 percent symptom resolution but requires 6–8 week recovery, 14.5–20 percent complication rate, and permanently removes the uterus. For women who want to keep their uterus, minimize recovery, or avoid major surgery, UFE is typically the better choice. For women wanting definitive permanent resolution with no desire for future fertility, hysterectomy is excellent.

This is one of the most common frustrations we hear — and it is valid. UFE is performed by interventional radiologists, not gynecologists. OB/GYNs are surgeons trained to perform surgical solutions like hysterectomy and myomectomy. Many are unfamiliar with UFE or do not routinely discuss it. A 2024 survey found only 17 percent of fibroid patients recalled being offered UFE. This is not a criticism of gynecologists — they are excellent physicians. It reflects the reality that different specialists offer different treatments. Dr. Bourgeois is happy to coordinate with your existing gynecologist.

For women under 45, the risk of premature ovarian failure is approximately 3 percent. For women over 45, the risk increases to up to 15 percent. The FEMME trial found no significant difference in FSH hormone levels between UFE and myomectomy patients at 12 months, which is reassuring. UFE targets the blood supply to fibroids specifically — the ovaries receive blood from separate vessels. However, in some cases, microscopic particles may reach ovarian blood supply, which is why the risk is slightly higher for older women whose ovarian blood supply may be more dependent on uterine artery branches.

Treated fibroids rarely regrow if they are completely infarcted (blood supply fully blocked). However, new fibroids can develop from different locations in the uterus over time. At five years, 73 to 80 percent of patients maintain symptom control. The retreatment rate is approximately 20 percent within five years — comparable to the 22 percent or higher recurrence rate after myomectomy. If retreatment is needed, options include repeat UFE, myomectomy, or hysterectomy.

You receive conscious sedation through an IV (awake but relaxed and comfortable). A tiny 2-millimeter puncture is made in the wrist or groin. A thin catheter is threaded through the arterial system to the uterine arteries using real-time X-ray guidance. Contrast dye maps the blood supply. Microscopic particles are injected to block the arteries feeding the fibroids. The process is repeated on both sides. The catheter is removed and a small bandage applied. The entire procedure takes 60 to 90 minutes. No incisions. No stitches.

Most patients report improved sexual health after UFE as fibroid symptoms resolve. Pain during intercourse caused by fibroids typically improves. Heavy bleeding that disrupted intimacy resolves. Pressure symptoms that caused discomfort decrease. There is no evidence of negative sexual function impact from UFE. Many women describe regaining a part of their life that fibroids had taken away.

Yes. Black women develop fibroids two to three times more often than white women, at younger ages (60 percent by age 35 versus 40 percent by age 35 for white women), and with more severe symptoms. Despite this higher prevalence, research shows Black women are 45 percent less likely to receive minimally invasive treatment like UFE. Every woman — regardless of race — deserves to know about all available treatment options. Dr. Bourgeois is committed to equitable access to care.

Yes. Dr. Austin Bourgeois performs UFE in Huntsville, eliminating the 100-plus-mile drive to Birmingham or Nashville that was previously required. He accepts Blue Cross Blue Shield of Alabama, TRICARE, Medicare, and all major insurance plans. The practice serves women throughout North Alabama including Decatur, Athens, Florence, Madison, and southern Tennessee.

You do not need a referral to schedule a consultation with Dr. Bourgeois for most insurance plans. TRICARE Prime members need a referral from their primary care manager. BCBS Alabama and most commercial plans allow self-referral to specialists with prior authorization (which our team handles). Call our office or complete the contact form — we will verify your insurance and guide you through the process.