Effects of uterine artery embolization on ovarian function

Purpose: To evaluate the ovarian functional reserve after uterine artery embolization (UAE) treatment for uterine fibroids (UF) of premenopausal women.

Materials and methods: In this retrospective study enrolled 65 consecutive patients, aged 37 – 48 years, which underwent UAE for symptomatic UF. UAE consisted of unilateral femoral artery puncture, bilateral selective catheterization of uterine arteries using 4-F Cobra 1 or Simmons 1 catheters, superselective catheterizations with microcatheters 2.7-F (bypassing vaginal and cervical arteries or even ovarians) and use of precise calibrated polyzene coated microspheres 700 µm in diameter as embolic material. Patients answered a questionnaire regarding menopausal symptoms and hormonal markers (FSH, AMH) was evaluated before and after UAE at the 1^st, 3^rd, 6^th and 12^th month, aside with imaging (MRI) evaluation.

Results: Bilateral UAE was successfully performed in cases. A significant elevation in FSH levels on the 1^st, 3^rd postoperative month was observed, reaching a peak value on the 3^rd postoperative month; subsequently, FSH levels started to decline, and returned to baseline level on the 12^th postembolization month. While a statistically significant reduction in the levels AMH was observed on the first postoperative month, reaching their minimum value on the 3^rd postoperative month; subsequently. AMH started to increase, and returned to baseline level on the 12^th postembolization month. Complete elimination of clinical climacteric symptoms occurred after 3 months.

Conclusion: This study confirm that 3 – 12 months after UAE the patients instate normal clinical and hormonal status.