Rock-a-bye Baby: Uterine Fibroid Embolization Shows Fertility Rates Comparable to Myomectomy

First Global Study Indicates Comparable Fertility Rates for Minimally Invasive
UFE and 'Gold Standard' Surgical Myomectomy for Women Who Want to Have
Children After Uterine Fibroid Treatment

TAMPA, Fla., March 15 /PRNewswire-USNewswire/ -- Uterine fibroid
embolization, a minimally invasive interventional radiology procedure that
blocks blood supply to treat painful uterine fibroids, has a comparable
fertility rate to myomectomy, the surgical removal of uterine fibroids, for
women who want to conceive, according to the first study on the subject
released at the Society of Interventional Radiology's 35th Annual Scientific
Meeting in Tampa, Fla.

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"This study is significant because it shows comparable fertility rates between
the two primary uterus-sparing treatments widely available to treat fibroids:
uterine fibroid embolization (UFE) and surgical myomectomy, which is
considered the gold standard for symptomatic fibroids in women who wish to
conceive," said Joao Martins Pisco, M.D., an interventional radiologist at
St. Louis Hospital in Lisbon, Portugal. "These results are surprising because
other studies have favored surgical myomectomy over UFE for women who want to
conceive. In this study of 743 women, UFE had a fertility rate of 58.1
percent, which is comparable to surgical fibroid removal (myomectomy), which
has a fertility rate of 57 percent," noted Pisco. "Our study proves that UFE
not only allows women who were unable to conceive to become pregnant but also
allows them to have normal pregnancies with similar complication rates as the
general population in spite of being a high risk group," he added. "In the
future, UFE will probably be a first-line treatment option even for women who
wish to conceive and are unable due to the presence of uterine fibroids," he
noted.

Uterine fibroids are benign tumors in the uterus that can cause prolonged,
heavy menstrual bleeding that can be severe enough to cause anemia or require
transfusion, disabling pelvic pain and pressure, urinary frequency, pain
during intercourse, miscarriage, interference with fertility and an abnormally
large uterus resembling pregnancy. Twenty to 40 percent of American women 35
and older have uterine fibroids, and nearly 50 percent of premenopausal
African American women have fibroids of a significant size.

An increasing number of women are delaying pregnancy until their late
thirties, which is also the most likely time for fibroids to develop, said
Pisco. There is conflicting evidence in the medical literature regarding the
impact of fibroids on pregnancy; however, the risk and type of complication
appear to be related to the size, number and location. Women may not know they
have fibroids (asymptomatic) and undergo in vitro fertilization treatments --
rather than getting treatment for fibroids. "We want women to know that
uterine fibroids may be a cause of infertility, that their treatment is
mandatory and that UFE may be the only effective treatment for some women,"
said Pisco.

The conventional treatment of uterine fibroids in patients who wish to become
pregnant is myomectomy, which is surgical fibroid removal. This treatment is
usually effective, particularly if the fibroids are in small number and of
small or medium size. UFE, which has a lower complication rate than
myomectomy, may be performed if a woman has many fibroids or large-sized
fibroids and a gynecologist cannot rule out a hysterectomy (uterus removal)
during myomectomy or if myomectomy is unsuccessful.

In the Portuguese study, most women opted for UFE as a fertility treatment
after failure of myomectomy or in vitro fertilization or because hysterectomy
was the only suggested option. Of the 743 patients who received UFE treatment,
74 wanted to conceive and had been unable. Of these 74 women, 43 or 58.1
percent (average age, 36.2) became pregnant; the time between UFE and
conception ranged from 2 to 22 months. At this time, there have been 36
completed pregnancies, resulting in 30 births (83.3 percent); seven women are
still pregnant.

"Most of the pregnancies after uterine fibroid embolization had good outcomes
with few complications. The complication rate of the pregnancies was expected
to be higher than the general population because these were high-risk patients
who had already undergone fertility treatments and were unable to conceive,"
said Pisco. "However, the percentage of the spontaneous abortions (11.1
percent), pre-term delivery (10.0 percent) and low birth weight (13.3 percent)
was the same as the general population," he stated.

Uterine fibroid embolization is performed by interventional radiologists.
These physicians are board certified and fellowship trained to perform this
and other types of embolization and minimally invasive targeted treatments. An
interventional radiologist makes a tiny nick in the skin, about the size of a
pencil tip, and inserts a catheter into the femoral artery. Using real-time
imaging, the physician guides the catheter through the artery and then
releases tiny particles, the size of a grain of sand, into the blood vessels
feeding the fibroid, cutting off its blood flow and causing it to shrink and
symptoms to subside. Most women return home the same day and can resume normal
activities within two to five days afterwards.

Myomectomy is usually major surgery that involves cutting out the biggest
fibroid or collection of fibroids and then stitching the uterus back together.
Most women have multiple fibroids, and it is not physically possible to remove
all the fibroids because it would remove too much of the uterus. While
myomectomy is frequently successful in controlling symptoms, the more fibroids
the patient has, generally, the less successful the surgery. In addition,
fibroids may grow back. Because of this, myomectomy surgery often needs to be
repeated.

This was a small retrospective study based on patients being treated for
fibroids by UFE in a single institution, said Pisco. He said that larger,
multicentered, randomized prospective studies are needed comparing UFE and
myomectomy.

More information about the Society of Interventional Radiology, interventional
radiologists and uterine fibroid embolization or UFE can be found online at
www.SIRweb.org.

Abstract 50: "The Outcome of Pregnancy Following Uterine Fibroid
Embolization," J.M. Pisco, M. Duarte and T. Bilhim, all at St. Louis
Hospital, Lisbon, Portugal, and the Faculty of Medical Sciences, New
University of Lisbon, Lisbon, Portugal, SIR 35th Annual Scientific Meeting
March 13-18, 2010, Tampa, Fla. This abstract can be found at
www.SIRmeeting.org.

About the Society of Interventional Radiology

Interventional radiologists are physicians who specialize in minimally
invasive, targeted treatments. They offer the most in-depth knowledge of the
least invasive treatments available coupled with diagnostic and clinical
experience across all specialties. They use X-ray, MRI and other imaging to
advance a catheter in the body, such as in an artery, to treat at the source
of the disease internally. As the inventors of angioplasty and the
catheter-delivered stent, which were first used in the legs to treat
peripheral arterial disease, interventional radiologists pioneered minimally
invasive modern medicine. Today, interventional oncology is a growing
specialty area of interventional radiology. Interventional radiologists can
deliver treatments for cancer directly to the tumor without significant side
effects or damage to nearby normal tissue.

Many conditions that once required surgery can be treated less invasively by
interventional radiologists. Interventional radiology treatments offer less
risk, less pain and less recovery time compared to open surgery. Visit
www.SIRweb.org.

The Society of Interventional Radiology is holding its 35th Annual Scientific
Meeting March 13-18 in Tampa, Fla. The theme of the meeting is "IR
Innovation," celebrating the remarkable inventiveness of SIR members and
highlighting the contributions made to both creating the field of
interventional radiology and improving patient care.

SOURCE Society of Interventional Radiology

Maryann Verrillo, +1-703-460-5572 or Diane Shnitzler, +1-703-460-5582, or
March 11-12: Lisa Tadje, +1-212-453-2137, or March 11-12: Don Murphy,
+1-212-453-2462, or March 11-12: Neil Hochman, +1-212-453-2067, all of the
Society of Interventional Radiology, or March 13-18: the Tampa Press Room,
+1-813-276-6905, +1-813-276-6906, +1-813-276-6912, comm@SIRweb.org