AJR:192, June 2009 1 [12, 13], and cervical ectopic pregnancy [14– 16] has been reported. The effects of embolization on ovarian function are important when preservation of fertility is desired. Few articles have focused on the effect of UAE for fibroids and its out- come on future fertility and pregnancy. To the best of our knowledge, pregnancy after UAE has been described in the literature in the form of case reports [17–20], a review article [21], and retrospective reports of case series [22– 29]. As of March 2008, more than 170 pa- tients worldwide had become pregnant after UAE. At a university-affiliated referral hospi- tal in Iran, we evaluated the pregnancies of women who underwent UAE for symptomat- ic fibroids and desired to become pregnant. Subjects and Methods From November 2001 to November 2004, we performed UAE on 102 women (mean age, 35.7 ± Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies Kavous Firouznia 1 Hossein Ghanaati 1 Mina Sanaati 2 Amir H. Jalali 3 Madjid Shakiba 3 Firouznia K, Ghanaati H, Sanaati M, Jalali AH, Shakiba M 1 Department of Radiology, Medical Imaging Center, Tehran University of Medical Sciences, University of Tehran, Keshavarz Blvd., Tehran 1419733141, Iran. Address correspondence to K. Firouznia. 2 Department of Gynecology, Eghbal Hospital, Tehran, Iran. 3 Research Unit, Medical Imaging Center, Tehran University of Medical Sciences, University of Tehran, Tehran, Iran. Women’s฀Imaging฀•฀Original฀Research AJR 2009; 192:1–5 0361–803X/09/1926–1 © American Roentgen Ray Society U terine fibroids are among the most common benign tumors of the female pelvis that cause ab- normal menstrual bleeding. Uter- ine artery embolization (UAE) in the man- agement of uterine myomas was first reported by Ravina et al. in 1995 [1]. Their promising results were confirmed in several uncon- trolled cohort studies, which showed an ap- proximately 50% decrease in uterine volume and relief of symptoms in 80–90% of pa- tients [2]. The advantages of UAE include lower cost and more rapid recovery than can be achieved with conventional therapies [3– 5]. The efficacy of uterine embolization in the management of pelvic hemorrhage has been well documented in obstetrics and gy- necology [6–8]. Successful pregnancy out- come after embolization for obstetric hemor- rhage [9, 10], gestational trophoblastic tumor [11], arteriovenous anomaly of the uterus 06_07_3904_WI 03.20.09 Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery DOI:10.2214/AJR.07.3904 Received February 27, 2008; accepted after revision November 12, 2008. Please see the commentary on this article, which appears on the following pages. WOMEN’S IMAGING PROOF Copyrighted Material For Review Only • Not for Distribution Page Copy OBJECTIVE. The purpose of this study was to report on pregnancies and their outcome after uterine artery embolization for uterine fibroids. SUBJECTS฀AND฀ METHODS. From 2001 to 2004, 102 patients (mean age, [± SD] 35.7 ± 6.4 years; range, 20–48 years) with symptomatic uterine fibroids underwent uterine ar- tery embolization with 500- to 710-μm polyvinyl alcohol particles. The mean uterine volume was 552 ± 649 cm 3 (range, 94–4,656 cm 3 ), and the dominant fibroid size was 228 ± 359 cm 3 (range, 14–2,618 cm 3 ) before the procedure. During the 2-year follow-up period, the patients were asked whether they were trying to achieve pregnancy and whether they were success- ful. We obtained pregnancy and obstetric records of the pregnant women from physicians’ offices and hospitals. RESULTS. Among 102 women who underwent bilateral uterine artery embolization, 23 (22.5%) were seeking to become pregnant, and 14 of the 23 (61%) became pregnant, nine having been nulliparous. One patient had two pregnancies. Fourteen pregnancies were spon- taneous, and one was achieved by zygote intrafallopian transfer. Two miscarriages occurred, one in the 12th and one in the 16th week of gestation. The other 13 pregnancies went to term, were uncomplicated, and ended in elective cesarean delivery. All of the neonates were healthy with Apgar scores greater than 8. The mean weight of the neonates was 3,274 ± 514.4 g (range, 2,100–3,950 g). One neonate was small for gestational age (2,100 g). CONCLUSION. Uterine artery embolization can serve as a substitute for invasive oper- ations such as hysterectomy and myomectomy. Additional studies, including prospective, ran- domized comparisons with myomectomy, should be performed to ascertain whether uterine artery embolization is a safe procedure for women who want to preserve their fertility. Firouznia et al. Pregnancy After Uterine Artery Embolization Women’s Imaging Original Research