Good preparation for uterine fibroid embolization (UFE) starts weeks before the procedure. Most of it is straightforward: confirm the diagnosis, review your health history and medicines, get insurance approval, and set up a calm few days at home afterward. This checklist is built from guidance by ACOG, RadiologyInfo (the American College of Radiology and Radiological Society of North America patient site) and the CIRSE 2015 guideline. Your own doctor's instructions always come first, because practices differ on details such as fasting times and which tests they order.
Your UFE preparation checklist
| When | What to do |
|---|---|
| At or after your consultation | Complete imaging and any tests your doctor orders; discuss your goals, including any wish to become pregnant |
| 2 to 4 weeks before | Insurance approval; plan time off work; arrange a driver and someone to stay with you |
| 1 to 2 weeks before | Review every medicine and supplement with your doctor; ask which to pause; fill prescriptions you are given |
| The day before | Confirm arrival time and place; set up your recovery space; pack your bag |
| Procedure morning | Follow fasting instructions; wear loose clothes; leave jewelry at home |
The timings above are a practical guide, not a medical rule. Ask your doctor's office for its own schedule.
Step 1: Confirm the diagnosis with imaging and tests
Before UFE, your doctor needs a clear picture of your fibroids: how many there are, where they sit and how big they are. NICE (the UK's national guideline body) says the uterus and fibroids should be assessed by ultrasound before UFE or myomectomy, with MRI considered when more detail on position, size, number and blood supply is needed. The CIRSE 2015 guideline calls MRI with gadolinium contrast the preferred imaging test. RadiologyInfo also notes you will have MRI or ultrasound of the uterus beforehand.
Many programs also want recent cervical screening (a Pap test) and sometimes a sample of the uterine lining, to make sure something other than fibroids is not causing your bleeding. Your doctor may ask for blood tests as well. Ask which tests you need and whether your gynecologist can do them. If you have imaging from elsewhere, bring the report and the images. Our guide to ultrasound and MRI for fibroids explains what each test shows.
Step 2: Talk through your goals and health history
This is the time to raise anything that could change whether UFE is right for you. Tell your doctor if you:
- Are or might be pregnant, or want a future pregnancy. RadiologyInfo says pregnant patients should not have UFE. ACOG supports UFE for women who want to keep their uterus, with counseling about the limited data on pregnancy afterward.
- Have an IUD. The CIRSE 2015 guideline lists an IUD in place as a relative contraindication, so ask whether it should be removed.
- Have had a reaction to X-ray contrast dye or local anesthetic. RadiologyInfo asks patients to list these allergies.
- Have kidney disease or a bleeding disorder. CIRSE lists impaired kidney function and clotting problems as relative contraindications.
- Have a pelvic infection, or have had pelvic cancer or pelvic radiation. Active uterine infection and cancer of the uterus or ovaries are contraindications in the CIRSE guideline, and Aetna's policy background also lists prior pelvic radiation.
- Smoke. ACOG lists smoking among the things to tell your doctor before UFE.
If you are close to menopause, ask how UFE might affect your periods and hormones. The CIRSE 2015 guideline notes that UFE can bring on early menopause, especially in women older than 45, while the risk to the ovaries seems overestimated in women under 40. If you are in your mid-40s or older, ask your doctor how this applies to you, and whether your symptoms might ease on their own as menopause approaches. Bring a written list of questions to ask before UFE so nothing is missed.
Questions about your treatment options? Dr. Fox can help.
Book a ConsultationThis article is part of our Fibroid Treatment Guide.
Step 3: Review your medicines
Make a complete list of everything you take, including vitamins, herbal supplements and over-the-counter pain relievers. RadiologyInfo says your doctor may advise you to stop aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners for several days before the procedure. Do not stop a prescribed blood thinner on your own. The doctor who prescribed it and your UFE doctor should agree on a plan.
Also ask what pain medicine you will go home with, and whether prescriptions can be filled before the procedure day so you are not waiting at a pharmacy afterward.
Step 4: Sort out insurance approval
Insurance plans often cover UFE when fibroids cause symptoms such as heavy bleeding or pressure, but rules differ. Aetna's 2026 policy, for example, considers UFE medically necessary for persistent symptoms caused by fibroids, such as heavy menstrual bleeding, pelvic pain or pressure, and urinary symptoms. Ask your insurer whether advance approval (prior authorization) is required, and ask the doctor's office who requests it and what records are needed. Our article Is UFE covered by insurance? explains the process, including appeals.
Step 5: Plan your time off and help at home
RadiologyInfo says most people return to normal activities within one to two weeks. Cramping is strongest in the first 24 hours. Some women go home the same day and others stay overnight, so ask which to expect. Arrange:
- A driver for the trip home. You cannot drive after sedation.
- Someone to stay with you for at least the first night.
- Time off work. A week is a common starting point for desk jobs; ask about longer if your work is physical.
- Help with children, pets and errands for the first few days.
At home, set up a comfortable rest area with water, light snacks, sanitary pads, a thermometer, your medicines and your doctor's phone number within reach. Ask your doctor's office who to call after hours.
Step 6: The night before and the morning of UFE
- Fasting: RadiologyInfo says you will likely be asked to fast after midnight. ACOG says you may not be able to eat or drink for several hours beforehand. Follow your own instructions exactly, including which medicines to take with a sip of water.
- Clothes: Wear loose, comfortable clothing and leave jewelry at home.
- Bring: Photo ID, insurance card, your medicine list, any outside imaging, and a small bag with essentials in case you stay overnight.
- Arrive on time: Confirm the address, arrival time and check-in instructions the day before.
Knowing what comes next helps many people feel calmer. Read what happens during UFE for a step-by-step walk-through, and our fibroid treatment guide for how UFE compares with other options.
When to call before your procedure
Call your doctor's office before the procedure day if you develop a fever or infection, think you could be pregnant, start a new medicine, or have very heavy bleeding with dizziness or shortness of breath. Heavy bleeding with lightheadedness or fainting needs same-day care.
Frequently Asked Questions
Do I need an MRI before UFE?
Imaging is needed to confirm that fibroids are causing your symptoms and that UFE suits them. The CIRSE 2015 guideline calls contrast MRI the preferred imaging test, and NICE advises ultrasound first with MRI when more detail is needed. Your doctor will tell you which you need.
Should I stop my medicines before UFE?
Possibly. RadiologyInfo says your doctor may ask you to stop aspirin, anti-inflammatory pain relievers or blood thinners for several days beforehand. Never stop a blood thinner on your own; ask the doctor who prescribed it and your UFE doctor.
Can I eat before UFE?
Usually not for several hours. RadiologyInfo says many doctors ask you to fast after midnight, and ACOG says you may not be able to eat or drink for several hours beforehand. Follow the exact instructions you are given.
How much time off should I plan?
Most women return to normal activities within about 1 to 2 weeks. In the FIRSTT trial, the median time off work after UFE was 8 days. Plan extra time if your job is physical.
Do I need someone with me?
Yes. Because you receive sedation, RadiologyInfo advises having someone drive you home, and it helps to have someone with you for the first day or two.
Keep Reading
- Uterine Fibroid Embolization (UFE) in New York City
- What Happens During UFE: A Step-by-Step Walk-Through
- UFE Recovery Day by Day: What to Expect Week by Week
- 15 Questions to Ask Before Uterine Fibroid Embolization
- Am I a Candidate for UFE? A Practical Checklist
- Is UFE Covered by Insurance in New York?
- Fibroid Treatment Guide: every option, compared
Sources
- RadiologyInfo.org (ACR/RSNA) — Uterine Fibroid Embolization
- American College of Obstetricians and Gynecologists, FAQ522 — Uterine Artery Embolization (last reviewed May 2026)
- van Overhagen & Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization
- NICE guideline NG88 — Heavy menstrual bleeding: assessment and management (updated July 2026)
- ACOG Practice Bulletin No. 228, Obstet Gynecol, 2021 — Management of symptomatic uterine leiomyomas
- Aetna Clinical Policy Bulletin 0304 — Fibroid Treatment (last review April 2026)
Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.
Living with heavy periods, pelvic pressure or other fibroid symptoms? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether uterine fibroid embolization is right for you. Call (212) 362-3470 or request a UFE consultation online.
