Ovarian Function After Uterine Artery Embolisation (Research Article) (Report‪)‬

Uterine artery embolisation (UAE) has been firmly established as a non-surgical modality for treatment of symptomatic myomas in women wishing to retain the uterus. Since the original paper by Ravina et al. (1) describing symptomatic relief and a dramatic decrease in uterine size after UAE, interventional radiologists together with gynaecologists have increasingly used this novel approach for treating myomas. Large cohort studies have since been published, all describing the excellent relief of symptoms related to myomas experienced after UAE. (2-5) A remarkable feature of this modality is its reproducibility: there is a surprising similarity in the findings of different centres using UAE. A South African study on UAE has shown symptomatic improvement and complications comparable to the rest of the world. (6) Exposure of the ovaries to radiation is a concern, especially if the patient desires future fertility. The calculated radiation dose to the ovaries is 20 rads during UAE. This dose is comparable to that for a barium enema or a hysterosalpingogram, but less than radiation treatment of Hodgkin's disease. Based on the well-established risks of pelvic radiation for Hodgkin's disease, it is concluded that the dose during UAE poses no risk for acute and long-term radiation injury, or to fertility. (7) Measures to minimise the radiation to the ovaries include pulsed fluoroscopy (to decrease the radiation dose), avoidance of detailed fluorography and strict coning down to the catheter tip.