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UFE AND FERTILITY: WHAT YOU NEED TO KNOW

Honest Answers About Pregnancy, Menopause Risk, and Preserving Your Options

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Fertility is often the most emotionally complex part of the fibroid treatment decision. If you are a woman in your 20s, 30s, or early 40s dealing with symptomatic fibroids, the question of how treatment will affect your ability to have children weighs heavily on every option you consider. You deserve complete, honest information — not reassuring generalities — so you can make the right decision for your life.

This page provides the clinical data, the nuances, and the practical guidance you need.

 

 

UFE and Fertility

The Bottom Line — Upfront

Actively planning pregnancy soon Myomectomy is the recommended first-line treatment. It has better documented fertility outcomes and is endorsed by both the Society of Interventional Radiology and the American College of Obstetricians and Gynecologists as the preferred approach for fertility preservation.
Not planning immediately, but want to keep the option open UFE preserves your uterus and maintains the biological possibility of pregnancy. Published pregnancy rates after UFE are 23 to 41.5 percent.
Fertility is not a consideration UFE and hysterectomy should both be evaluated based on your symptom severity, recovery preferences, and personal priorities.

Pregnancy Rates: UFE vs. Myomectomy

After UFE
23 – 41.5%
The most encouraging data comes from the Pisco study of 359 infertile women treated with partial UFE — 41.5% pregnancy rate and 131 live births. Other studies report 23–32%.
After Myomectomy
48 – 55.9%
Consistently higher than UFE across all published studies. Miscarriage rates closer to the general population (10–15%).

Miscarriage rates after UFE are approximately 20 percent, somewhat higher than the general population rate of 10 to 15 percent. After myomectomy, miscarriage rates are closer to the general population.

Our honest take: These numbers matter, and we present them without spin. Myomectomy has a meaningful fertility advantage over UFE in the current literature.

Does UFE Cause Early Menopause?

This is one of the most common fears — and the answer depends heavily on your age.

Women Under 45
~3% risk
The FEMME trial found no significant difference in ovarian reserve between UFE and myomectomy at 12 months.
Women Over 45
Up to 15% risk
Older ovaries may depend more on blood supply from uterine artery branches affected during embolization.
The takeaway: The risk is not zero, and it should be part of your decision-making. But for most women of reproductive age, the data indicates that UFE does not significantly accelerate menopause compared to surgical alternatives.

When UFE Makes Sense Despite Fertility Goals

When myomectomy is technically not feasible

Some fibroid patterns — many large fibroids, deeply intramural fibroids, or fibroids in locations that make surgical removal excessively risky — may make myomectomy dangerous or impossible. In these cases, UFE may be the only uterus-preserving option.

When previous myomectomy has failed

Fibroids recur after myomectomy in over 22 percent of cases. For women facing a second or third myomectomy with increasing surgical risk, UFE offers an alternative approach.

When pregnancy is a future possibility but not an active plan

If you are years away from wanting to conceive but need symptom relief now, UFE provides that relief while keeping the uterus intact. The fertility data, while less favorable than myomectomy, still shows meaningful pregnancy rates.

During your consultation, Dr. Bourgeois discusses your fibroid pattern, your fertility timeline, and your options with complete transparency. If myomectomy is clearly the better choice for your situation, he will tell you and provide a referral to a gynecologic surgeon.

What to Discuss with Your Care Team

1 What is my specific fibroid pattern, and does it affect which treatment is better for fertility?
2 Is myomectomy technically feasible for my fibroids?
3 What are the risks of myomectomy given my specific anatomy?
4 What is my ovarian reserve, and does my age affect the menopause risk from UFE?
5 What is my fertility timeline — am I planning pregnancy in the next year, or is this about preserving future options?
6 What would you recommend if I were your sister?

Dr. Bourgeois addresses all of these questions during your consultation and coordinates with your gynecologist and reproductive endocrinologist to ensure you have the full picture.

Ready to discuss your options? Dr. Bourgeois provides honest, transparent guidance tailored to your situation.

Discuss Your Options with Dr. Bourgeois
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