Leiomyoma is the most common benign tumor occurring in the uterus and in the female pelvis. It is estimated that 25% of women over the age of 35 years have leiomyoma. Accordingly, not all women with myoma should be treated. As women continue to delay their childbearing until the third and fourth decades of life, leiomyoma will be encountered more frequently.

One of the newest treatments of uterine leiomyomata is uterine artery embolization (UAE). The main purpose of UAE is to reduce the size of the myomata and to treat excessive uterine bleeding. In a review of 119 cases of UAE, the authors reported that about 70% of the patients had an immediate cessation of menorrhagia and improvement of pain and pressure symptoms after the procedure. At six months follow-up, the total uterine volume decreased by 56% and the average diameter of the largest myoma decreased by 36%.

The purpose of this review is to evaluate the effects of UAE on reproductive function.

Uterine fibroids and fertility

The association between leiomyoma and infertility has been discussed for many years. Current evidence suggests that leiomyoma that deforms the uterine cavity decreases fertility. This could be related to poor implantation site or to impaired gamete transport. The best evidence came from the experience in in vitro fertilization (IVF).