ReviewCVIR endovascular2023
Uterine artery embolisation: fertility, adenomyosis and size - what is the evidence?
Review in CVIR endovascular, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Reproductive outcomes after fertility-sparing interventions for symptomatic adenomyosis: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) effectively reduces fibroid-related symptoms and improves quality of life-A prospective single-centre 12-month follow-up study.Acta obstetricia et gynecologica Scandinavica · 2025Trial
- [Uterine fibroids-Minimally invasive treatment with embolization].Radiologie (Heidelberg, Germany) · 2026Review
- Uterine artery embolization with or without methotrexate followed by D&C versus D&C alone for cervical pregnancy: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Uterine Artery Embolization as an Alternative Therapeutic Option in Adenomyosis: An Observational Retrospective Single-Center Study.Journal of clinical medicine · 2025Article
- Management of Entero-Uterine Fistula Which Developed Following Trans-Arterial Embolization of Arteriovenous Malformation Associated with Gestational Trophoblastic Neoplasia.Journal of obstetrics and gynaecology of India · 2025Article
- Successful treatment of subinvolution of the placenta site with uterine artery embolisation, sparing the patient's fertility: A case report.Case reports in women's health · 2025Article
- Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients' quality of life.Open medicine (Warsaw, Poland) · 2025Article
- Uterine artery projection relative to anatomical bony landmarks in CT-angiographies.Surgical and radiologic anatomy : SRA · 2024Article
- Evaluation of junctional zone differential and ratio as possible markers of clinical efficacy in uterine artery embolisation of adenomyosis.CVIR endovascular · 2024Article
- Surgical evacuation combined with Shirodkar cervical suture and selective uterine artery embolization: A fertility preserving treatment for 10-15 weeks' live cesarean scar ectopic pregnancies.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Getting it right is better than being right, right?CVIR endovascular · 2024Article
- Update on Endovascular Therapy for Fibroids and Adenomyosis.Seminars in interventional radiology · 2023Review
- Interventional radiology in woman's health: room for improvement.CVIR endovascular · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUterine artery embolisation is well established as a treatment for symptomatic fibroids, however, there remain some uncertainties. We have carried out a focused literature review on three particularly challenging aspects - post-procedure fertility, symptomatic adenomyosis and large volume fibroids and uteri, to enable operators to utilise evidence-based guidance in patient selection, consent, and management. REVIEW: Literature searches were performed of the PubMed/Medline, Google scholar, EMBASE and Cochrane databases. The outcomes of our analysis of studies which recorded fertility rates in women desiring pregnancy following UAE for symptomatic fibroids found an overall mean pregnancy rate of 39.4%, live birth rate of 69.2% and miscarriage rate of 22%. The major confounding factor was patient age with many studies including women over 40 years who already have lower fertility compared to younger cohorts. Miscarriage rates and pregnancy rates in the studies analysed were comparable to the age matched population. Treatment of pure adenomyosis and adenomyosis with co-existing uterine fibroids with UAE has been shown to produce symptomatic improvement with better outcomes in those with combined disease. Although the effectiveness is not as high as it is in pure fibroid disease, UAE provides a viable and safe alternative for patients seeking symptom relief and uterine preservation. Our analysis of studies assessing the outcomes of UAE in patients with large volume uteri and giant fibroids (> 10 cm) demonstrate no significant difference in major complication rates demonstrating that fibroid size should not be a contraindication to UAE.
conclusionOur findings suggest uterine artery embolisation can be offered to women desiring pregnancy with fertility and miscarriage rates comparable to that of the age-matched general population. It is also an effective therapeutic option for symptomatic adenomyosis as well as for the treatment of large fibroids > 10 cm in diameter. Caution is advised in those with uterine volumes greater than 1000cm
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.