The honest answer is that uterine fibroid embolization works well for most women, but "success" depends on what you measure and how far out you look. In large studies, most women report much lighter bleeding and less pressure within the first year. Over time, a share of women go on to need another procedure: about 1 in 10 needed a hysterectomy within 3 years in a large US registry, and about 1 in 3 did within 10 years in a Dutch randomized trial of women who were all hysterectomy candidates. Both numbers are true. They describe different groups of women.
This article walks through the 1, 2, 5 and 10-year evidence so you can see where the often-quoted figures come from. For an overview of the procedure itself, see our main page on uterine fibroid embolization (UFE).
What "success" means in fibroid studies
When you read a success rate, check which of these it means:
- Technical success: the doctor was able to block the blood flow to the fibroids during the procedure. The CIRSE 2015 guideline gives a technical success rate of 95% to 97%.
- Symptom relief: bleeding, pain, pressure and urinary symptoms improve, usually measured with a questionnaire.
- Satisfaction: whether women are glad they had the procedure.
- Avoiding further treatment: whether women still have their uterus and have not needed a repeat embolization, myomectomy or hysterectomy years later.
A clinic that quotes one big number without saying which of these it means is not giving you the full picture. Patient information sources also differ: ACOG's patient FAQ says about 3 in 4 women who had UAE got relief from fibroid symptoms and about 1 in 5 later needed another surgery for their fibroids, while RadiologyInfo, a radiology society site, says nearly 90 percent of patients experience relief. Neither figure tells you how long the relief lasted.
The first year: symptom relief
The FIBROID Registry is the largest US study of UFE, following more than 2,000 women treated at 27 sites. At 1 year, the average symptom score fell from about 59 to about 19 on a 100-point scale, where lower is better, and quality-of-life scores rose from about 47 to about 87. About 82% of women said they were satisfied, and 2.9% had needed a hysterectomy.
In the UK REST trial, a randomized study of 157 women, quality of life at 1 year was similar after UFE and surgery, although symptom scores were somewhat better after surgery. In that first year, 9% of the UFE group needed a repeat embolization or a hysterectomy.
Results take time to show. ACOG says it may take 2 to 3 months to notice a change in your symptoms, and that fibroids may keep shrinking for a year or more. The CIRSE 2015 guideline says the maximal effect is seen at about 6 months.
Two years: how UFE compares with surgery
The Cochrane review, which pooled 7 randomized trials with 793 women, found no clear difference in satisfaction at 2 years between UFE and surgery (hysterectomy or myomectomy). The trade-off was re-treatment. If about 7% of women need further surgery within 2 years of hysterectomy or myomectomy, the review estimated that between 15% and 32% would need it within 2 years of UFE.
The FEMME trial, which compared UFE with myomectomy in 254 women, found that quality-of-life scores at 2 years favored myomectomy by about 8 points on a 100-point scale. At 4 years, that difference had narrowed to 5 points and was no longer statistically significant. If you are deciding between these two options, our article on UFE vs myomectomy covers the details.
Questions about your treatment options? Dr. Fox can help.
Book a ConsultationThis article is part of our Fibroid Treatment Guide.
Three to five years: the durability question
At 3 years, the FIBROID Registry reported that symptom and quality-of-life scores had improved by about 41 points each and had moved into the normal range. The estimated rates of further treatment by 3 years were 9.79% for hysterectomy, 2.82% for myomectomy and 1.83% for a repeat UFE. This was a single-arm registry, so there was no comparison group.
The randomized trials show more re-treatment. In the Dutch EMMY trial, 28.4% of women in the UFE group had a hysterectomy by 5 years. In the REST trial, 32% of the UFE group needed another procedure for treatment failure or complications by 5 years, compared with 4% after surgery. At the same time, REST found that symptom relief and satisfaction were very high in both groups at 5 years. The authors concluded that the less invasive nature of UFE needs to be weighed against re-intervention in almost a third of patients, and that the choice should lie with the informed patient.
Ten years: the longest follow-up
EMMY is the only randomized trial with 10-year results. Of 81 women who had UFE, 28 (35%) had a hysterectomy within 10 years. Put the other way, about two thirds avoided a hysterectomy. Quality of life was stable and similar between the UFE and hysterectomy groups, and 78% of UFE patients were satisfied or very satisfied, compared with 87% after hysterectomy. Our UFE vs hysterectomy article looks at that trial in more depth.
| Time point | Study | What happened after UFE |
|---|---|---|
| 1 year | FIBROID Registry (US, 2005) | 82% satisfied; 2.9% had a hysterectomy |
| 2 years | Cochrane review (7 trials, 2014) | Satisfaction similar to surgery; 15% to 32% estimated to need further surgery |
| 3 years | FIBROID Registry (US, 2008) | Hysterectomy 9.79%, myomectomy 2.82%, repeat UFE 1.83% |
| 5 years | EMMY trial (Netherlands, 2010) | 28.4% had a hysterectomy |
| 5 years | REST trial (UK, 2011) | 32% needed another procedure (vs 4% after surgery) |
| 10 years | EMMY trial (Netherlands, 2016) | 35% had a hysterectomy; about two thirds kept the uterus |
Why the numbers differ between studies
Registries and randomized trials enroll different women. EMMY only enrolled women who were already candidates for hysterectomy, often with larger fibroids and more severe symptoms. Registries tend to include a wider range of patients. Trials also follow women more closely, so more re-treatments are recorded. Finally, whether another procedure happens depends partly on choice: a woman with partial relief may decide to live with it, or may choose surgery.
The CIRSE 2015 guideline summarizes the trial evidence this way: after a technically successful UFE, about 75% to 80% of women can expect to avoid hysterectomy over 5 years.
What seems to predict a better result
In the FIBROID Registry, women with smaller fibroids, fibroids just under the uterine lining (submucosal), and heavy bleeding as their main symptom improved the most. A 2010 study of 71 women with very large fibroids concluded that a large fibroid burden should not be considered a reason to rule out UFE, although it can shape what you should expect; our UFE candidate checklist covers the factors doctors look at.
Your own odds also depend on whether your symptoms are truly coming from the fibroids, or partly from another condition such as adenomyosis, which has its own, separate body of embolization research. A careful evaluation with imaging before the procedure helps answer these questions. The CIRSE 2015 guideline names contrast-enhanced MRI as the preferred imaging test.
If UFE does not work well enough
A less-than-hoped-for result does not close any doors. Women in these studies went on to have repeat embolization, myomectomy or hysterectomy. Because re-treatment is more common after UFE than after surgery, it is worth asking any doctor how they follow patients after the procedure and what they recommend if symptoms return. You can read more about these and other trade-offs in UFE risks and complications, and compare every option side by side in our fibroid treatment guide.
Frequently Asked Questions
What is the success rate of uterine fibroid embolization?
It depends on how success is measured. Technical success is 95% to 97% (CIRSE 2015 guideline), about 82% of women were satisfied at 1 year in the FIBROID Registry, and about two thirds avoided hysterectomy over 10 years in the EMMY trial.
How long do the results of UFE last?
For many women, years. In the FIBROID Registry, symptom scores were still in the normal range at 3 years. In EMMY, 35% of women had a hysterectomy within 10 years, which means about 65% did not.
Is UFE more likely to need a repeat procedure than surgery?
Yes. The Cochrane review and the REST trial both found higher re-treatment after UFE. In REST, 32% of UFE patients needed another procedure by 5 years, compared with 4% after surgery.
How soon will I know whether UFE worked?
ACOG says it may take 2 to 3 months to notice a change in symptoms, and fibroids may keep shrinking for a year or more. The CIRSE 2015 guideline says the full effect is usually seen by about 6 months.
Why do some websites say 85% to 90% success?
Some patient sources, such as RadiologyInfo, say nearly 90% of patients get symptom relief. That reflects short-term relief. It does not tell you how many women need another procedure later, which is why long-term trial data matter.
Keep Reading
- Uterine Fibroid Embolization (UFE) in New York City
- UFE vs Hysterectomy: What 10 Years of Trial Data Show
- UFE vs Myomectomy: Results, Recovery and Fertility Compared
- UFE Risks and Complications: What the Numbers Show
- Am I a Candidate for UFE? A Practical Checklist
- UFE Recovery Day by Day: What to Expect Week by Week
- Fibroid Treatment Guide: every option, compared
Sources
- Spies et al., Obstet Gynecol, 2005 — FIBROID Registry 1-year outcomes
- Goodwin et al., Obstet Gynecol, 2008 — FIBROID Registry 3-year outcomes (2,112 patients)
- Gupta et al., Cochrane Database Syst Rev, 2014 — uterine artery embolization for symptomatic fibroids (7 trials, 793 women)
- Hehenkamp et al., Am J Obstet Gynecol, 2007 — EMMY trial 2-year results
- van der Kooij et al., Am J Obstet Gynecol, 2010 — EMMY trial 5-year results
- de Bruijn et al., Am J Obstet Gynecol, 2016 — EMMY trial 10-year results, UAE vs hysterectomy (177 women)
- Edwards et al., N Engl J Med, 2007 — REST trial, UAE vs surgery at 1 year (157 women)
- Moss et al., BJOG, 2011 — REST trial 5-year results
- Manyonda et al., N Engl J Med, 2020 — FEMME trial, UAE vs myomectomy (254 women)
- Daniels et al., Int J Gynaecol Obstet, 2023 — FEMME trial 4-year results
- van Overhagen and Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization
- Smeets et al., Cardiovasc Intervent Radiol, 2010 — UAE in women with a large fibroid burden (71 women)
- ACOG patient FAQ — Uterine Artery Embolization (last reviewed May 2026)
- RadiologyInfo.org (ACR/RSNA) — Uterine Fibroid Embolization
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.
