83 - Fertility Outcomes Following Uterine Fibroid Embolization versus Myomectomy: A Multi-Center Observation Study

Sunday, April 12, 2026

3:18 PM - 3:27 PM ET

Author/Co-author(s)

AB

Ansh Bhatia, MD

IR Resident
Department of Interventional Radiology, University of Miami, India
Rohit Reddy, MD

IR Resident
Department of Interventional Radiology, University of Miami, United States
Waseem Wahood, MD, MS

Resident
Jackson Memorial Hospital, University of Miami, United States

Presenting Author(s)

AG

Anders Gould, MD

Resident
University of Miami, Miller School of Medicine, United States

Author/Co-author(s)

RT

Renil S. Titus, MD

Research Fellow
Department of Urology, Houston Methodist Hospital., United States
US

Usman Shahid, MD

Attending
University of Miami, United States

Purpose: To compare fertility-related outcomes between women treated with uterine fibroid embolization (UFE) and myomectomy for symptomatic uterine fibroids.

Materials and Methods: This retrospective cohort study utilized the TriNetX US-Collaborative Network, encompassing 71 health-systems. Two cohorts of reproductive-age women (18-40 years) with uterine fibroids: 524 patients who underwent UFE and 15,879 patients who underwent myomectomy. Patients were matched on 37 characteristics including demographics, BMI categories, fibroid-subtypes, comorbidities, and medications, yielding 522 matched pairs. Outcomes included pregnancy rates, ectopic pregnancy, and postpartum haemorrhage_(PPH) over a 10-year period.

Results: After propensity score matching, baseline characteristics were well-balanced between groups. Mean follow-up was 755 days for UFE and 672 days for myomectomy-patients. UFE-patients did not have a statistically significant difference in overall pregnancy rates compared to myomectomy patients (18.6% vs 21.5%; RR:0.866, 95% CI:0.679-1.105; p=0.246). However, time-to-event showed a trend toward delayed pregnancy in UFE patients that approached statistical significance (HR:0.763, 95% CI:0.581-1.002; p=0.050)(Figure-1). Ectopic pregnancy rates were similar between groups (1.9% vs 1.9%, p=0.548). UFE patients demonstrated a numerically higher but non-significant rate of postpartum hemorrhage (3.8% vs 2.3%; risk ratio 1.667, 95% CI 0.823-3.374; p=0.151).

Conclusion: This multi-center analysis found that pregnancy rates are similar between UFE and myomectomy in reproductive-age women with uterine fibroids, though there was a trend toward delayed time to pregnancy following UFE that approached statistical significance. Ectopic pregnancy and PPH rates were not different between treatments. These findings suggest that both treatments may have comparable fertility outcomes, with potential counseling considerations regarding timing of conception and hemorrhage risk for reproductive-age women considering these fibroid treatment options.