Pregnancy After UFE: Honest Numbers and What They Mean

Yes, women do get pregnant and have healthy babies after uterine fibroid embolization (UFE). But the evidence is limited, and in the few direct comparisons, pregnancy rates were lower and miscarriage rates higher after UFE than after myomectomy. In a 2025 French study, 13 of the 46 women who tried to conceive after UFE (28%) became pregnant, and 9 (20%) had a baby. ACOG recommends that anyone choosing UFE be counseled about the limited data on pregnancy afterward. If having a baby is a priority, myomectomy is usually discussed first, and UFE is kept for situations where surgery is difficult or risky.

What the guidelines say

• ACOG (American College of Obstetricians and Gynecologists), 2021: recommends uterine artery embolization for patients who want to keep the uterus and who are counseled about the limited data on reproductive outcomes. ACOG's patient guide puts it simply: "The effect of UAE on future pregnancies is not clear."
• CIRSE 2015 guideline: lists a wish for future pregnancy as a relative contraindication, meaning UFE can still be considered but needs careful discussion.
• NICE (UK), 2018, updated 2026: advises doctors to explain that UFE or myomectomy "may potentially allow them to retain their fertility."

None of these says UFE is off-limits for women who want children. All of them say the decision deserves an honest conversation.

The numbers, study by study

Why the evidence is so hard to read

The studies point in slightly different directions, and there are good reasons for that. The numbers are small. In FEMME, more women got pregnant after UFE than after myomectomy, while Mara's trial found the opposite. Neither trial was large enough on its own to settle the question.

Age also matters a great deal. In many UFE studies, women are around 40 on average, an age when fertility is already lower for everyone. In the Fabre study, the average age of women trying to conceive was 40, and 43% had already had at least one myomectomy. Many of them were choosing UFE precisely because surgery had already been tried or looked risky. That makes their results hard to compare with younger women who have never had fibroid surgery.

This article is part of our Fibroid Treatment Guide.

When UFE may still make sense if you hope to conceive

The Fabre authors framed their results this way: "Fertility may be preserved in a subset of women with complex surgical histories or high-risk surgical profiles." In practice, UFE is more often considered for women who want a pregnancy when:

• They have had one or more previous myomectomies and scarring makes another operation difficult
• Their fibroids are so many, or placed so that removing them surgically would likely mean a hysterectomy
• They have medical reasons that make major surgery risky
• They would otherwise be heading toward a hysterectomy, which would end the chance of carrying a pregnancy

If none of these applies to you, and pregnancy is a clear goal, it is worth hearing a gynecologic surgeon's view on myomectomy. Our comparison of UFE vs myomectomy sets out the trade-offs in more detail.

Re-treatment matters when you are planning a family

Another factor to weigh is the chance of needing more treatment later. The 2014 Cochrane review estimated that if 7% of women need further surgery within 2 years of hysterectomy or myomectomy, between 15% and 32% would after UFE. For a woman trying to conceive, a second procedure can mean more time lost.

Myomectomy has its own trade-offs. ACOG recommends it for patients who want to keep the uterus or want a future pregnancy and who are counseled about the risk of fibroids coming back. It is a surgical operation, with a longer recovery than UFE in the trials, and new fibroids can grow afterward. Neither option is risk-free, which is why a plan built around your age, your fibroids and your timeline matters more than any single statistic.

What about egg supply and ovarian function?

A common worry is that UFE could harm the ovaries. A 2020 review of 6 studies (353 women) found no significant change in the hormone markers of egg supply (AMH and FSH) after UFE, including in women under 40. The CIRSE 2015 guideline says the risk of ovarian problems "seems overestimated" in women under 40. The risk rises with age, which we cover in will UFE cause early menopause?

If you become pregnant after UFE

Tell your obstetrician early that you have had UFE, and share your imaging and procedure reports. In the Fabre study, all babies were delivered by cesarean and 3 of the 13 pregnancies ended in early miscarriage. Those figures come from a single center and a small group, so they do not predict what will happen to you, but they are a reason for careful prenatal care. We did not find a reliable source for how long to wait after UFE before trying to conceive, so ask your doctors for their advice.

Questions to ask before you decide

• Given my age and my fibroids, would you recommend myomectomy instead if I want a baby?
• Could my fibroids be removed without risking a hysterectomy?
• Should I see a fertility specialist before choosing a treatment?
• How long would you advise waiting after UFE before trying to conceive?
• What extra monitoring would I need during a pregnancy after UFE?

For the bigger picture of results, risks and recovery, see our guide to uterine fibroid embolization (UFE). To compare every option, including those most often chosen to protect fertility, see our fibroid treatment guide. And if you are unsure whether UFE fits you at all, start with am I a candidate for UFE?

Frequently Asked Questions

Can you get pregnant after uterine fibroid embolization?

Yes, pregnancies and live births after UFE are well documented. Rates vary widely between studies, and the evidence quality is low, so no one can give you a precise chance.

Is myomectomy better than UFE for fertility?

The limited evidence leans toward myomectomy. A 2008 randomized trial found more pregnancies and deliveries after myomectomy, though the FEMME trial later found more pregnancies after UFE, with numbers too small to be sure.

Does UFE increase the risk of miscarriage?

Some studies suggest a higher miscarriage rate after UFE than after myomectomy, but a 2018 review rated this evidence as very low quality. Age also affects miscarriage risk.

Will I need a cesarean after UFE?

Not necessarily. In one 2025 single-center study all births after UFE were by cesarean, but that small group does not set a rule. Your obstetrician will advise you based on your own pregnancy.

What does ACOG say about UFE and pregnancy?

ACOG recommends UFE for patients who want to keep the uterus and are counseled about the limited data on pregnancy afterward. Its patient guide says the effect on future pregnancies is not clear.

Keep Reading

• Uterine Fibroid Embolization (UFE) in New York City
• UFE vs Myomectomy: Results, Recovery and Fertility Compared
• Will UFE Cause Early Menopause? Ovarian Function and Age
• Am I a Candidate for UFE? A Practical Checklist
• 15 Questions to Ask Before Uterine Fibroid Embolization
• Fibroid Treatment Guide: every option, compared

Sources

1. ACOG Practice Bulletin No. 228, Obstet Gynecol, 2021 — Management of symptomatic uterine leiomyomas
2. ACOG patient FAQ, Uterine Artery Embolization (last reviewed May 2026)
3. Gupta et al., Cochrane Database Syst Rev, 2014 — uterine artery embolization for symptomatic fibroids (7 trials, 793 women)
4. Mara et al., Cardiovasc Intervent Radiol, 2008 — randomized trial of UAE vs myomectomy in women with reproductive plans (121 women)
5. Karlsen et al., Arch Gynecol Obstet, 2018 — pregnancy after UAE: systematic review (17 studies, 989 patients)
6. Daniels et al., Int J Gynaecol Obstet, 2023 — FEMME trial 4-year outcomes, UAE vs myomectomy
7. Fabre et al., CVIR Endovascular, 2025 — fertility outcomes after UAE for symptomatic leiomyomas (210 patients)
8. van Overhagen & Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE Standards of Practice: uterine artery embolization for symptomatic leiomyomata
9. NICE guideline NG88, Heavy menstrual bleeding: assessment and management (updated July 2026)
10. El Shamy et al., Acta Obstet Gynecol Scand, 2020 — impact of UAE on ovarian reserve: systematic review and meta-analysis (6 studies, 353 women)

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.