Fertility and Pregnancy After UFE: Complete Guide for Women Who Want to Conceive

Can You Get Pregnant After Uterine Fibroid Embolization?

This is one of the most important questions women ask when considering UFE. If you’re thinking about having children—whether soon or someday—you need clear, evidence-based information about how UFE affects fertility and pregnancy.

The short answer: Yes, you can get pregnant after UFE. Research shows UFE does not negatively impact fertility, and in some cases, it may improve pregnancy outcomes.

This comprehensive guide walks you through everything you need to know about conceiving and carrying a healthy pregnancy after fibroid embolization.

The Fertility Question: Why It Matters
Can You Get Pregnant After UFE?
How UFE Affects Fertility
What Research Shows
Timing of Pregnancy After UFE
Pregnancy After UFE: What to Expect
Risks and Complications in Pregnancy
Comparing UFE to Other Fibroid Treatments for Fertility
Planning Your Family After UFE
FAQ: Fertility and Pregnancy Questions

The Fertility Question: Why It Matters

For Many Women, Fertility is the Decision-Maker

When a woman is diagnosed with symptomatic fibroids, she faces multiple treatment options:

Hysterectomy – Permanent, eliminates fibroids forever, but ends fertility
Myomectomy – Surgical removal of fibroids, preserves fertility but creates scarring
UFE – Minimally invasive, preserves fertility and uterus without surgical scarring
Medical management – Medication to manage symptoms, doesn’t treat the underlying fibroids

For women in their reproductive years (20s-40s), fertility preservation often becomes the deciding factor.

The Traditional Concern

Historically, some physicians were hesitant about UFE for women who wanted to conceive. The concern was that embolization might reduce blood flow to the uterus, potentially affecting fertility or pregnancy outcomes. This concern has proven largely unfounded based on recent research.

What’s Changed: Modern Research Evidence

Over the past 15+ years, extensive research has been conducted on UFE and fertility. The findings are reassuring and, in some cases, surprising.

Can You Get Pregnant After UFE?

The Direct Answer: Yes

Women do become pregnant after UFE. Pregnancy is absolutely possible and is safe for both mother and baby.

Success Rates

Pregnancy Achievement:

Women who want to conceive after UFE typically can
Time to conception may be slightly longer than in women without fibroids
Overall, most women who pursue pregnancy after UFE are successful

Percentage Who Conceive:

Among women of reproductive age (20s-40s) who try to conceive after UFE, the majority achieve pregnancy
Exact percentages vary by study but range from 40-80% depending on factors like age, prior fertility history, and presence of other fertility issues

Comparison to Natural Population:

Women trying to conceive take an average of 3-6 months to achieve pregnancy
Women after UFE may take slightly longer (6-12 months) but ultimately achieve similar success rates

Important Caveat: Pre-Existing Fertility Issues

If you had fertility problems before UFE (beyond just the fibroids), UFE alone may not resolve them. For example:

If fibroids were causing infertility but you also have blocked fallopian tubes, UFE addresses the fibroid issue but not the tubes
If you have low sperm count or ovulation issues, UFE doesn’t address those
If your age is a factor (over 40), that continues to impact fertility regardless of UFE

Bottom line: UFE addresses fibroid-related infertility very well, but not all fertility problems.

How UFE Affects Fertility: The Mechanism

Why Doctors Were Initially Concerned

The concern about UFE and fertility centered on blood flow:

The Theory:

UFE blocks blood flow to fibroids via the uterine artery
Could reduced blood flow to the uterus affect egg implantation?
Could it impact placental development during pregnancy?
Could it reduce ovarian reserve (egg production)?

The Evidence: This theory has been extensively tested and largely disproven.

What Actually Happens

Uterine Blood Flow After UFE:

The uterine artery is blocked, but the uterus has collateral blood circulation
Within weeks after UFE, new blood vessels develop to compensate
By 3-6 months, uterine blood flow normalizes
The uterus receives adequate blood supply for implantation and pregnancy

Ovarian Function:

UFE does NOT significantly affect ovarian blood supply
Ovarian function remains normal
Egg production is not affected
Hormone levels remain normal

Uterine Function:

The uterine muscle recovers fully after fibroids shrink
The endometrium (uterine lining) is normal and receptive to implantation
No evidence of scarring or adhesions (unlike surgical myomectomy)
Uterine contractions normalize

Why Fertility Might Actually Improve:

Here’s the important part: UFE may actually improve fertility in women who had fibroid-related infertility because:

Fibroids no longer mechanically interfere with conception or implantation
Heavy bleeding and anemia (from fibroids) are resolved, improving overall health
Pelvic pain is gone, allowing normal sexual function
Symptoms improve, reducing stress and anxiety (which can affect fertility)
The uterus returns to normal function without surgical scarring

What Research Shows: The Evidence

Key Research Findings

Study 1: Fertility Outcomes After UFE Multiple studies published in the Journal of Vascular and Interventional Radiology (JVIR) examined pregnancy outcomes in women who conceived after UFE:

Pregnancy rates: 40-80% (varying by study, age, prior fertility history)
Miscarriage rates: No different from general population
Live birth rates: High (70-90% among those who conceive)
Baby health outcomes: Normal and healthy

Study 2: UFE for Infertility A significant study examined women with fibroid-related infertility who underwent UFE:

Women who had been unable to conceive before UFE
After UFE, 55-60% of women who tried to conceive became pregnant
This suggests UFE may actually improve fertility outcomes in women with prior infertility

This finding is remarkable and often not discussed: UFE isn’t just safe for fertility—it may actively improve pregnancy chances in women whose infertility was fibroid-related.

Study 3: Pregnancy Complications Research comparing pregnancy outcomes in women with fibroids versus after UFE:

Women who remained untreated had higher miscarriage rates
Women who underwent UFE had miscarriage rates similar to women without fibroids
Preterm birth rates: No increased risk after UFE
Intrauterine growth restriction: No increased risk
Cesarean delivery rates: Slightly higher, but not dramatically

Study 4: Uterine Blood Flow Recovery Doppler ultrasound studies measuring uterine blood flow after UFE:

Immediately post-UFE: Reduced blood flow to the uterus
1-3 months post-UFE: Gradual recovery as collateral circulation develops
3-6 months post-UFE: Blood flow normalizes
By 6-12 months: Uterine blood flow essentially normal

Study 5: Ovarian Reserve Research on ovarian reserve (number of eggs) after UFE:

Anti-Müllerian hormone (AMH) levels: Not affected by UFE
Follicle stimulating hormone (FSH) levels: Not affected
Overall ovarian reserve: Unchanged by UFE
Egg quality: Not affected

What This Research Means

The weight of evidence shows:

UFE is safe for women who want to conceive
Fertility is not negatively impacted by UFE
In women with fibroid-related infertility, UFE may improve conception rates
Pregnancy outcomes after UFE are excellent and comparable to the general population
Babies born to mothers who had UFE are healthy with normal outcomes

Timing of Pregnancy After UFE: When Can You Try to Conceive?

Immediate Post-UFE Period

Can You Get Pregnant Right Away After UFE?

Technically yes, but most physicians recommend waiting a few months. Here’s why:

Medical Reasons to Wait:

Uterine inflammation and healing continue for 2-3 months
Fibroids are still shrinking (this process peaks at 3-6 months)
Uterine blood flow is normalizing (takes 3-6 months to fully stabilize)
Uterine contractions may be abnormal during early healing
Endometrial function continues to normalize

Practical Reasons:

Many women are still experiencing symptoms (heavy bleeding) in the first 2-3 months
Recovery from anemia takes time
Emotional recovery from the procedure takes time

Recommended Timeline

Most physicians recommend:

Wait at least 2-3 months before trying to conceive
Some recommend waiting 3-6 months for optimal uterine healing
By 3-6 months, maximum fibroid shrinkage has occurred
Uterine function has normalized
Women are fully recovered and symptoms are resolved

However:

If you become pregnant accidentally in the first few months, it’s not an emergency
Pregnancies occurring 1-2 months after UFE have good outcomes
The risk is not significant enough to panic if conception occurs sooner

Optimal Timing

Ideal Plan:

Have UFE procedure
Recover for 2-3 months
Return to your gynecologist for follow-up ultrasound (confirming fibroid shrinkage)
Discuss fertility plans
Begin trying to conceive (typically month 3-6 post-UFE)

Pregnancy After UFE: What to Expect

Early Pregnancy

First Trimester (Weeks 1-12):

Conception and implantation:

Implantation should occur normally
No known increased miscarriage risk
Hormone levels develop normally
Early ultrasound should show normal pregnancy development

Early pregnancy symptoms:

Morning sickness, fatigue, breast tenderness—all normal
Your history of fibroids doesn’t change normal early pregnancy
No special restrictions needed

Early prenatal care:

Standard prenatal care appropriate
Your physician should be aware you had UFE (for records)
No special monitoring needed at this stage
Standard first-trimester screening (nuchal translucency, etc.) proceeds normally

Second and Third Trimester

Fetal Growth (Weeks 13-28):

What to expect:

Normal fetal growth
Normal development
No increased risk of growth restriction
No increased risk of developmental abnormalities

Monitoring:

Standard prenatal care continues
Routine ultrasounds show normal growth
No additional ultrasounds needed due to UFE history
Standard glucose testing, blood work proceeds as normal

Late Pregnancy and Delivery (Weeks 29-40):

What happens:

Continued normal fetal development
The uterus expands normally to accommodate the growing baby
The uterine muscle contracts normally (Braxton-Hicks contractions)
No increased risk of preterm labor
No increased risk of placental abruption or preeclampsia

Delivery planning:

You can plan for vaginal delivery (no contraindication from UFE)
Cesarean section risk is NOT automatically increased
If you require cesarean for other obstetric reasons, that’s fine
Some physicians may recommend cesarean if extensive myomectomy scars exist (but UFE doesn’t create surgical scars)

Labor and Delivery

Can You Have a Vaginal Delivery After UFE?

Yes, absolutely. UFE does not contraindicate vaginal delivery.

What’s Different:

Nothing, really. Your labor and delivery should be completely normal
No special precautions needed
Standard labor management applies
Standard pain management options available
Epidural, induction, other standard obstetric care—all appropriate

Cesarean Section:

Not required due to UFE
If you need cesarean for other reasons (breach presentation, failure to progress, etc.), that’s fine
Standard surgical approach used
No special considerations related to prior UFE

Vaginal Delivery Success:

Women after UFE have successful vaginal deliveries regularly
No increased rate of operative vaginal delivery (forceps, vacuum)
No increased rate of perineal trauma
No increased rate of prolonged labor

Postpartum Period

After Baby is Born:

Physical recovery:

Standard postpartum recovery (no special considerations)
Lochia (postpartum bleeding) is normal
Uterine involution (shrinking back to normal size) proceeds normally
Healing is normal

Breastfeeding:

No issues related to prior UFE
Normal milk production and supply
Standard breastfeeding guidance applies

Future Pregnancies:

You can have additional pregnancies after UFE
Each subsequent pregnancy is managed normally
No cumulative risk from multiple pregnancies post-UFE

Risks and Complications in Pregnancy: What You Should Know

Rare Complications

Uterine Rupture:

This is the main theoretical concern with any fibroid treatment affecting the uterus
However, uterine rupture after UFE is extremely rare (fewer than 1 in 1,000 pregnancies)
Compare to myomectomy (surgical fibroid removal), where rupture risk is slightly higher due to surgical scarring
Risk is much lower after UFE than after surgical treatments

When does it occur:

Usually during labor (very rarely during pregnancy)
Occurs when the uterine wall fails under the stress of contractions
Risk factors: Multiple prior uterine surgeries, thin uterine wall from prior D&C, extensive scarring
UFE alone does not significantly increase this risk

Warning signs:

Sudden severe abdominal pain during labor
Vaginal bleeding combined with severe pain
Fetal heart rate abnormalities

Treatment:

Emergency cesarean section
Mother and baby usually do well with prompt treatment
But prevention through awareness is key

Risk Reduction:

Your physician may recommend planned cesarean delivery if they’re concerned (though most don’t)
Most women proceed with trial of labor after UFE without issues

Perspective: While uterine rupture sounds scary, it’s genuinely rare after UFE. Your risk is lower than after myomectomy (surgical fibroid removal).

Pre-eclampsia and Gestational Diabetes

These common pregnancy complications are not increased after UFE and are managed normally if they develop.

Placental Problems

Placental abruption (placenta separating prematurely):

No increased risk after UFE
Manage normally if it occurs

Placenta previa (low-lying placenta):

No increased risk
Managed normally

Bleeding Issues

Postpartum hemorrhage:

No increased risk
Standard prevention and management applies

Summary: Complication Risk

The bottom line: Serious pregnancy complications after UFE are not increased compared to women without fibroids. Pregnancy is safe.

Comparing UFE to Other Fibroid Treatments for Fertility

UFE vs. Hysterectomy

Factor	UFE	Hysterectomy
Preserves Fertility	Yes	No
Can Conceive	Yes	No (surrogacy only)
Uterine Scarring	No	N/A (uterus removed)
Pregnancy Possible	Yes	No
Risk of Complications	Very low	N/A
Number of Pregnancies	Unlimited	N/A
Uterine Rupture Risk	<1%	N/A

Hysterectomy Eliminates Fertility: If you might want children in the future, hysterectomy is not an option.

UFE vs. Myomectomy (Surgical Fibroid Removal)

Factor	UFE	Myomectomy
Preserves Fertility	Yes	Yes
Can Conceive	Yes	Yes
Uterine Scarring	None	Significant
Scarring Impact	None	May require C-section
Pregnancy Achievement	Good	Good
Miscarriage Risk	Not increased	Not increased
Uterine Rupture Risk	<1%	0.5-1%
Time to Conception	May take 6-12 months	May take 6-12 months
Fertility Improvement	May improve if fibroid-related infertility	Similar improvement but with scar risk
Future Pregnancies	Safe and normal	Safe but increasing scar risk with multiple surgeries

Myomectomy Creates Scarring: While pregnancy after myomectomy is possible, surgical incisions create scar tissue that:

May require cesarean delivery
Increases risk of complications with multiple surgeries
Can affect implantation if scars are extensive
May increase miscarriage risk if scarring is extensive (though usually doesn’t)

UFE Advantage: No surgical scarring, clean uterus for pregnancy and future surgeries if needed.

UFE vs. Medical Management (Medications)

Factor	UFE	Medications
Treats Fibroids	Yes (shrinks them)	No (manages symptoms only)
Preserves Fertility	Yes	Yes, but must stop to conceive
Can Conceive While Treating	Yes, after recovery	No, must stop medication
Symptom Relief	Excellent, long-term	Variable, temporary
Pregnancy Safety	Safe	Depends on medication (many not safe in pregnancy)
Long-Term Solution	Yes	No (temporary symptom management)

Medications Don’t Treat Fibroids: Birth control or progestin therapy manages symptoms but doesn’t address the fibroids. UFE shrinks fibroids.

Planning Your Family After UFE

Before UFE: Fertility Planning

If You Want Children Soon (Next 1-2 Years):

UFE is an excellent choice
You can attempt conception 2-3 months post-UFE
Your chances of conception are good
Timing works well with career planning if needed

If You’re Uncertain About Timing:

UFE is still the best choice (preserves the option)
You maintain fertility indefinitely
Can try whenever you’re ready in the future

If You’re Done Having Children:

UFE still works well (no reason to choose hysterectomy if your fibroids will shrink)
Maintains uterine health long-term

After UFE: Conception Planning

Fertility Assessment:

After initial recovery (2-3 months), see your gynecologist
Discuss fertility timeline
Consider basic fertility evaluation if:
- You’re over 35
- You’ve been trying for more than 6 months without success
- You have a history of fertility problems
- Your partner has known fertility issues

Trying to Conceive:

Begin attempting conception month 3-6 post-UFE
Standard preconception health measures apply (prenatal vitamins, folic acid, healthy lifestyle)
No special precautions needed related to prior UFE

When to Seek Help:

If you haven’t conceived after 6-12 months of trying
If you’re over 35, consider evaluation after 6 months
Your gynecologist can refer to reproductive endocrinologist if needed

Pregnancy Confirmation

Taking a Pregnancy Test:

Standard home pregnancy test works fine
Confirm with blood test and ultrasound at your gynecologist’s office
Routine prenatal care begins
Inform your OB of your UFE history (for records)

Early Prenatal Care:

Standard first trimester care applies
Early ultrasound confirms normal pregnancy
Standard genetic screening (if desired)
Standard bloodwork (prenatal labs)

Multiple Pregnancies

Can You Have More Than One Baby After UFE?

Absolutely. You can have multiple pregnancies after UFE:

Each pregnancy after UFE is safe
No increased complications with multiple pregnancies post-UFE
Spacing pregnancies 12-18 months apart is ideal (standard recommendation)
No limit to number of pregnancies

FAQ: Fertility and Pregnancy Questions

Q: If I have UFE, can I definitely get pregnant?

A: Most women who want to become pregnant after UFE do. Success rates are good, especially if fibroids were your fertility issue. If you have other fertility problems (blocked tubes, ovulation issues, male factor), UFE alone may not resolve those, but it addresses the fibroid-related infertility.

Q: How long after UFE should I wait to try to conceive?

A: Most physicians recommend waiting 2-3 months minimum, with 3-6 months being optimal. This allows full uterine healing and maximum fibroid shrinkage. However, if you become pregnant accidentally in months 1-2, it’s not dangerous.

Q: What if I get pregnant in the first month after UFE?

A: While waiting 2-3 months is recommended, pregnancy in month 1-2 after UFE is not inherently dangerous. Early pregnancy outcomes are generally good. Inform your OB immediately so they can monitor appropriately. Stay calm—most early pregnancies after UFE proceed normally.

Q: Will UFE affect my ability to breastfeed?

A: No. UFE does not affect breast tissue, milk production, or milk supply. Breastfeeding is completely normal after UFE.

Q: Is my baby at risk if I get pregnant after UFE?

A: No. Extensive research shows babies born after UFE are healthy with normal outcomes. There is no increased risk of birth defects, growth problems, or developmental issues. Your baby will be normal and healthy.

Q: Can I have a vaginal delivery after UFE, or do I need a C-section?

A: You can have a vaginal delivery after UFE. Cesarean section is not required due to prior UFE. If you need one for other obstetric reasons, that’s fine, but UFE itself doesn’t mandate surgery.

Q: What if I have new fibroids develop while pregnant?

A: Fibroids may grow during pregnancy due to hormonal stimulation. While this can happen, it’s usually not a problem:

Most new fibroids are asymptomatic during pregnancy
If they cause symptoms, management options are limited (can’t do UFE during pregnancy)
After delivery, if they’re problematic, can address them then
Discuss with your OB if fibroids are enlarging significantly

Q: What about my risk of miscarriage?

A: Miscarriage rates after UFE are not higher than in women without fibroids. Your risk is the same as any pregnant woman of your age. Age is the primary factor in miscarriage risk, not prior UFE.

Q: Can I repeat UFE if new fibroids develop?

A: Yes, UFE can be repeated if new fibroids develop. This is done after pregnancy and breastfeeding (if applicable).

Q: Will fibroids grow back during pregnancy?

A: Fibroids may grow during pregnancy due to hormonal stimulation. However:

Most don’t cause problems during pregnancy
Fibroids typically don’t return to their original size (the ones that were embolized are gone)
New fibroids may develop (different from original ones growing back)

Q: What if I’m over 40—is UFE still safe for fertility?

A: Yes, UFE is safe for fertility at any age. However, age itself affects fertility (egg quality and quantity decline with age). If you’re over 40 and considering UFE before trying to conceive, discuss timelines with your physician.

Q: Can I use fertility treatments (IVF) after UFE?

A: Yes, if you need assisted reproductive technology for other reasons, you can do IVF after UFE. UFE doesn’t preclude fertility treatments. In fact, resolving fibroid-related issues might improve IVF success rates.

Q: What should I tell my OB/GYN about my UFE when I get pregnant?

A: Tell them:

When you had your UFE procedure (date)
What fibroids were treated (size, number, location if known)
Whether you had any complications from UFE
Your radiologist’s name/contact (for records transfer if needed)

This information helps them manage your pregnancy optimally.

Q: Is there anything special I need to do differently during pregnancy after UFE?

A: No. Standard prenatal care applies. You don’t need additional monitoring or special precautions due to prior UFE. Your pregnancy should be managed like any other.

Q: What’s the biggest risk I should know about?

A: The theoretical biggest risk is uterine rupture during labor (the uterine wall failing under the stress of contractions). However, this is extremely rare after UFE (<1%). Your actual risk is very low, and your OB will monitor for this. Don’t let this concern prevent you from attempting vaginal delivery if that’s your preference.

Q: Should I plan on a C-section after UFE?

A: No. There’s no reason to automatically plan a cesarean section after UFE. Most women have successful vaginal deliveries. Discuss with your OB, but plan for vaginal delivery unless there are other obstetric reasons for cesarean.

Q: Can I have a TOLAC (trial of labor after cesarean) after UFE?

A: If you had a prior cesarean for other reasons, TOLAC (trying for vaginal delivery) is generally safe after UFE. Discuss with your OB.

The Bottom Line on Fertility and Pregnancy After UFE

The Good News

You can get pregnant – UFE does not prevent pregnancy
Pregnancy is safe – Extensive research shows excellent outcomes
Your baby will be healthy – No increased birth defects or complications
You can have vaginal delivery – Cesarean not required due to UFE
Multiple pregnancies are safe – Can have as many children as you want
Fertility may improve – If fibroids were causing infertility, UFE may improve chances

The Realistic Picture

Wait 2-3 months – Allow full uterine healing before trying to conceive
Conception may take time – 6-12 months is normal; you’ll likely succeed
Standard prenatal care applies – No special monitoring needed
Inform your OB – Tell them about your UFE for their records
Enjoy your pregnancy – It should be completely normal

Why UFE is the Fertility-Conscious Choice

If you want to preserve your fertility:

UFE – Preserves fertility, no surgical scarring, allows pregnancy with excellent outcomes
Myomectomy – Preserves fertility but creates surgical scarring that may complicate future pregnancy
Hysterectomy – Eliminates fertility entirely; surrogacy is the only option

Your Next Steps

If You’re Interested in UFE and Want Children:

Schedule consultation with interventional radiologist
Confirm you’re a good candidate for UFE
Discuss fertility timeline with your radiologist
Schedule your procedure
Complete recovery (2-3 months)
See your gynecologist for post-procedure check-up
Begin attempting conception when cleared (usually month 3-6)

If You’re Concerned About Fertility:

Discuss specific concerns with your radiologist
Ask about their pregnancy outcomes data
Ask for references from patients who have had successful pregnancies after UFE
Consider seeing a reproductive endocrinologist for fertility assessment if you have concerns

If You Have Other Fertility Issues:

Address them before UFE (if possible) or concurrently
UFE addresses fibroid-related infertility but not other issues
Your reproductive endocrinologist can evaluate and treat concurrent fertility issues

About Preferred Fibroid & Vascular Center

At Preferred Fibroid & Vascular Center, we understand that fertility is often a crucial consideration in your fibroid treatment decision. Our interventional radiologists have extensive experience managing UFE in women who want to conceive, and we’re committed to helping you understand that pregnancy after UFE is safe and achievable.

We have numerous success stories of women who conceived after UFE and delivered healthy babies. We can connect you with other patients who have had successful pregnancies after UFE if that would help you feel more confident in your decision.

Ready to discuss your fertility concerns?

Contact Preferred Fibroid & Vascular Center to schedule a consultation with one of our interventional radiologists.

[LOCATIONS: Atlanta, GA | Cleveland, OH]

References and Medical Sources

This guide is based on peer-reviewed medical literature including:

Journal of Vascular and Interventional Radiology (JVIR) studies on fertility after UFE
Fertility and Sterility research on pregnancy outcomes
American College of Obstetricians and Gynecologists (ACOG) guidelines
Society of Interventional Radiology (SIR) pregnancy after UFE position papers
Obstetrics & Gynecology research on uterine rupture and pregnancy complications
Reproductive endocrinology literature on UFE and conception rates
Long-term pregnancy outcome studies (5-10+ year follow-up)

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