Uterine Fibroid Embolization (UFE) in New York City

Quick Answer

Uterine fibroid embolization (UFE) is a catheter procedure that blocks the blood supply to fibroids so they shrink, keeping the uterus and avoiding an abdominal incision. In randomized trials, satisfaction was similar to surgery and recovery was faster, though more women needed another procedure later.

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Heavy periods that soak through protection, pelvic pressure, running to the bathroom all day, a belly that looks swollen no matter what you do: fibroids can shape every part of your week. Many women are told that a hysterectomy is the main answer. It is not the only one. Uterine fibroid embolization (UFE), also called uterine artery embolization (UAE), treats fibroids without removing the uterus and without an abdominal incision.

This page explains what UFE is, what more than two decades of research show, who is a good candidate, how it compares with every other option, and what recovery really looks like. It is written by David Fox, MD, FACS, RPVI, a board-certified vascular surgeon who performs UFE and sees patients at our office on Third Avenue in Manhattan. We cover the trade-offs as plainly as the benefits, because the right choice depends on your symptoms, your fibroids and your plans. If you are still comparing every kind of treatment, our fibroid treatment guide lays them all out side by side.

What is uterine fibroid embolization?

Fibroids (leiomyomas) are noncancerous growths of the muscle wall of the uterus. They depend on a rich blood supply from the two uterine arteries. UFE cuts off that supply. A doctor places a thin, flexible tube called a catheter into an artery, usually at the top of the leg (the femoral artery) or at the wrist (the radial artery), and uses live X-ray guidance to steer it into the arteries that feed the uterus. Tiny particles, about the size of grains of sand, are then released into the small vessels feeding the fibroids. Starved of blood, the fibroids shrink and soften over the following months, and the bleeding and pressure they cause usually ease.

A few points help set expectations:

UFE and UAE are the same procedure. Gynecology papers and guidelines usually say "uterine artery embolization (UAE)". Patient materials often say "uterine fibroid embolization (UFE)".
It treats all the fibroids at once. Rather than removing fibroids one by one, UFE affects every fibroid fed by the uterine arteries, which can help when there are many.
The fibroids are not removed. They shrink. In the EMMY trial, the uterus shrank by about 48% and the largest fibroid by about 61% at two years. Other series report smaller reductions, so think of it as "about a third to a half smaller" rather than gone.
The effect builds slowly. ACOG's patient guidance says it may take 2 to 3 months to notice a change in symptoms and that fibroids may keep shrinking for a year or more. The CIRSE 2015 guideline says the full effect is usually seen by about six months.

UFE is designed for fibroids. Some women have a related condition called adenomyosis, where the lining tissue grows into the muscle of the uterus, and the two often occur together. Embolization has been studied for adenomyosis too, but results are less predictable. Our article on adenomyosis vs fibroids explains the difference, and an MRI usually tells them apart.

Who performs your UFE at Fox Vein Care

At Fox Vein Care, UFE is performed by David Fox, MD, FACS, RPVI. Dr. Fox is a board-certified vascular surgeon. His daily work is diagnosing and treating problems inside blood vessels, using catheters, imaging and the same kind of image-guided technique that UFE relies on. He performs the procedure himself.

What his credentials mean:

FACS means he is a Fellow of the American College of Surgeons. Fellowship requires board certification, a review of the surgeon's case list, references from other Fellows and an interview.
RPVI (Registered Physician in Vascular Interpretation) is a credential for interpreting vascular ultrasound studies. It is not an embolization credential, but it reflects the vascular imaging skills he uses every day.

Most UFE procedures in the United States are performed by interventional radiologists, as both RadiologyInfo (from the American College of Radiology and the Radiological Society of North America) and ACOG note. Vascular surgeons also perform UFE. An academic program at Rutgers described a vascular surgery-based UFE service in 2018: 26 procedures over 18 months, all technically successful, with no complications reported. That is a small series, but it shows the procedure fits within a vascular surgeon's skills. Our article on who performs UFE covers the differences between specialties and what to ask any doctor about their experience.

Fibroid care is a team effort. Your gynecologist confirms the diagnosis, checks for other causes of bleeding and stays involved in your care. Dr. Fox focuses on whether embolization fits your fibroids and on the procedure itself. You can read more about his background on Dr. Fox's profile.

Fibroid symptoms UFE can relieve

Fibroids are very common. In a well-known ultrasound study of 1,364 randomly selected women aged 35 to 49, the estimated chance of having fibroids by age 50 was more than 80% for Black women and nearly 70% for white women. Black women also tend to develop them earlier and with more severe symptoms. Many fibroids never cause trouble. Treatment makes sense when they affect your health or daily life.

The CIRSE 2015 guideline lists two main groups of symptoms that UFE is used for:

Heavy menstrual bleeding. Long or heavy periods, clots, flooding, and the tiredness and anemia that can follow.
Bulk or pressure symptoms. Pelvic pain or pressure, pain during sex, needing to urinate often or urgently, constipation, lower back pain or a visibly enlarged abdomen.

In the FIBROID Registry, a US study of more than 2,000 women treated with UFE at 27 sites, women whose main problem was heavy bleeding, and women with smaller fibroids or fibroids just under the lining of the uterus (submucosal), tended to improve the most. Pressure symptoms are also a common reason for UFE, but in that study bleeding was the symptom most linked to a strong response.

Am I a candidate for UFE?

UFE is typically considered if you:

Have fibroids that cause heavy bleeding, pain, pressure, or bladder or bowel symptoms
Want to keep your uterus, or want to avoid or delay major surgery
Have imaging, ideally MRI, showing that fibroids explain your symptoms
Do not plan a future pregnancy, or understand the uncertainty about pregnancy after UFE (see the next section)

The CIRSE 2015 guideline lists three situations where UFE should not be done: pregnancy, cancer of the uterus or ovaries (outside of special situations), and an active infection of the uterus. Other conditions need extra care but do not always rule UFE out. These include a wish for future pregnancy, an allergy to X-ray contrast dye, reduced kidney function, a bleeding disorder, an IUD in place, and fibroids that hang from a thin stalk.

Large, submucosal and pedunculated fibroids

Large fibroids. In a 2010 study of 71 women with a fibroid larger than 10 cm or a very large uterus, there were no serious complications and only 14% needed a hysterectomy over about four years. The authors concluded that a large fibroid burden should not be considered a reason to rule out UFE.
Submucosal fibroids sit against the lining of the uterus. They often respond well, but they are more likely to break down and pass through the cervix afterward. In a 2010 study of 20 dominant submucosal fibroids, half were completely expelled within a year. This is usually manageable but sometimes needs a minor procedure. Fibroids that bulge into the cavity can often be removed through the cervix instead, with hysteroscopic myomectomy.
Pedunculated fibroids hang from a stalk. CIRSE calls them a "controversial" relative contraindication when the stalk is thin. Small studies have treated them with few complications, but the stalk is assessed carefully on MRI first.

If you are over 45 or close to menopause

Fibroids usually shrink after menopause, so if your periods are already slowing down, waiting may be reasonable. UFE can also bring on menopause earlier in some women. The CIRSE 2015 guideline says this risk is higher in women over 45. In the FIBROID Registry, 7.3% of women stopped having periods after UFE, and 86% of them were 45 or older. Our UFE candidate checklist walks through these questions in more detail.

UFE and future pregnancy

If you hope to become pregnant, this is the most important part of the decision, and the evidence is honest about its limits. ACOG's 2021 practice bulletin recommends UAE for patients who want to keep their uterus, on the condition that they are counseled about the limited data on pregnancy afterward. ACOG's patient page puts it simply: the effect of UAE on future pregnancies is not clear.

Here is what the studies show. In a 2008 randomized trial of 121 women with plans for pregnancy, myomectomy led to more pregnancies (33 vs 17) and more deliveries (19 vs 5) in the first two years than UFE, and the authors concluded that myomectomy appeared to have better reproductive outcomes. The 2014 Cochrane review rated the fertility evidence as very low quality. In the UK FEMME trial, 12 women became pregnant after UFE and 6 after myomectomy over four years, a difference too small to draw conclusions from. A 2025 French study followed 46 women who tried to conceive after UFE (average age 40, many with earlier fibroid surgery): 28% became pregnant and 20% had a baby, all by cesarean birth.

So pregnancies after UFE do happen, but if having a baby is your priority, myomectomy is usually the first option to discuss. UFE may still make sense for women who cannot safely have more surgery or whose fibroids cannot be removed. Our article on pregnancy after UFE goes through each study and the questions to ask your gynecologist.

What the research shows

UFE is one of the most studied fibroid treatments, with several randomized trials comparing it directly with surgery. The table summarizes the main studies.

Study	Who was studied	Key findings
Cochrane review (2014)	7 randomized trials, 793 women, UFE vs hysterectomy or myomectomy	No clear difference in satisfaction at 2 and 5 years. Shorter hospital stay and faster return to usual activities with UFE. More repeat procedures: if 7% need more surgery within 2 years of surgery, 15% to 32% would after UFE.
EMMY trial, Netherlands (10-year results, 2016)	177 women eligible for hysterectomy, randomized to UFE or hysterectomy	Quality of life similar at 10 years. 35% of UFE patients (28 of 81) later had a hysterectomy, so about two in three avoided it. Back to paid work in about 28 days after UFE vs 63 after hysterectomy.
REST trial, UK (2007 and 2011)	157 women, UFE vs surgery (mostly hysterectomy)	No difference in quality of life at 1 or 5 years. Median hospital stay 1 day vs 5. By 5 years, 32% of UFE patients had needed another procedure, vs 4% after surgery.
FEMME trial, UK (2020 and 2023)	254 women who wanted to keep the uterus, UFE vs myomectomy	Myomectomy gave better fibroid-related quality of life at 2 years (about 8 points on a 100-point scale). By 4 years, the gap was smaller and no longer statistically significant.
FIBROID Registry, US (2005 and 2008)	More than 2,000 women at 27 US sites (no comparison group)	Symptom and quality-of-life scores improved by about 41 points by 3 years, moving into the normal range. 82% satisfied at 1 year. Within 3 years, about 10% had a hysterectomy, 3% a myomectomy and 2% a repeat UFE.
Fabre et al., France (2025)	210 women after UFE, 46 of whom tried to conceive	28% of those trying became pregnant and 20% had a baby. 70% needed no further fibroid treatment.
ACOG Practice Bulletin 228 (2021)	US guideline for gynecologists	Recommends UAE for patients who want to keep the uterus and are counseled about the limited data on pregnancy afterward.

Put simply, most women improve after UFE. RadiologyInfo says nearly 90% of patients get relief from their fibroid symptoms, and ACOG's patient page puts it at about 3 in 4. The difference depends on how relief is measured and for how long. Satisfaction is similar to surgery in randomized trials and recovery is faster, but more women need a second treatment later, and in FEMME myomectomy gave somewhat better quality of life at two years. Our article on UFE success rates explains what "success" means in each study and which factors predict a good result.

Questions about your treatment options? Dr. Fox can help.

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This article is part of our Fibroid Treatment Guide.

How UFE compares with other fibroid treatments

No single treatment is right for everyone. This table compares the main options. Click a treatment to read the full comparison.

Treatment	Uterus kept?	Incision?	Typical recovery	Chance of re-treatment	Fertility
Medication	Yes	None	None needed	Fibroids stay; ACOG notes surgery is often needed later	Hormonal birth control and the hormonal IUD prevent pregnancy while used
Uterine fibroid embolization (UFE)	Yes	A needle puncture at the groin or wrist	About 1 to 2 weeks to normal activities for many women; up to 4 to 6 weeks for some	Higher than surgery: about 1 in 3 by 5 years in REST	Pregnancy possible but data limited
Myomectomy	Yes	Abdominal or keyhole incisions, or none if done through the cervix	Longer than UFE in trials; depends on the approach	Lower than UFE; new fibroids can grow	Usually the first choice if you want to become pregnant
Hysterectomy	No	Abdominal, keyhole or vaginal	Longest: about 63 days to paid work in EMMY	None for fibroids	Pregnancy no longer possible
Radiofrequency ablation	Yes	Small keyhole incisions, or none if done through the cervix	Days; in one study more than half were back to normal within a day	About 8% to 11% by 3 years in single-arm studies	Limited data
Focused ultrasound	Yes	None	Days (about 4 days off work vs 8 after UFE in one trial)	Higher than UFE in the FIRSTT trial	Limited data

UFE vs myomectomy. Both keep the uterus. Myomectomy removes fibroids surgically and is usually preferred if you plan a pregnancy. In FEMME it gave better quality of life at two years, although the gap narrowed by four years. UFE avoids an incision, treats many fibroids at once and has a shorter recovery, at the cost of a higher chance of another procedure later. Our full UFE vs myomectomy comparison covers who tends to do better with each.

UFE vs hysterectomy. Hysterectomy is the only treatment that ends fibroid bleeding for certain, and the EMMY authors said it remains the choice when certainty matters most. But in EMMY, quality of life was the same at ten years, UFE patients went back to work about five weeks sooner, and about two in three never needed a hysterectomy. If you have been told hysterectomy is your only option, read UFE vs hysterectomy, and consider a second opinion before hysterectomy.

Radiofrequency ablation and focused ultrasound suit selected fibroids depending on their size, number and position. In the FIRSTT trial, focused ultrasound meant a quicker recovery, but more women needed another treatment later than after UFE.

Before UFE: evaluation, imaging and approval

A careful workup is what makes UFE safe and effective. It usually includes:

A gynecologic evaluation. To confirm that fibroids explain your symptoms and to rule out other causes of bleeding. Some published programs also require a recent Pap test and an endometrial biopsy (a sample of the uterine lining) before UFE.
Imaging. The CIRSE 2015 guideline names contrast-enhanced MRI as the preferred imaging before UFE. NICE, the UK guideline body, advises an ultrasound first and an MRI when more detail is needed about the position, size, number and blood supply of the fibroids. MRI can also show adenomyosis and fibroids on a stalk, which change the plan.
Blood tests. NICE advises a full blood count for every woman with heavy menstrual bleeding, to check for anemia. Kidney function may also be checked, because the procedure uses X-ray contrast dye.
Insurance approval. Many plans review UFE for medical necessity before treatment (see the insurance section below).

Bring your questions to the consultation. Our list of questions to ask before UFE covers experience, follow-up, pain control and what happens if symptoms return.

The day of your procedure

What follows is what is typical according to RadiologyInfo and ACOG. Dr. Fox will explain exactly how your own procedure day is set up.

Before you arrive. You will usually be asked not to eat or drink for several hours beforehand, to wear loose clothing and to arrange for someone to drive you home.
Anesthesia. UFE is typically done with a sedative and local anesthesia, so you are relaxed and drowsy but not fully asleep.
Access. The catheter goes in through a small puncture at the groin (femoral artery) or the wrist (radial artery). There is no abdominal incision and no stitches. In a 2021 randomized trial of 153 women, wrist and groin access were equally effective and safe.
Treating both sides. Using X-ray guidance, the doctor treats both uterine arteries so that every fibroid's blood supply is reduced. RadiologyInfo says UFE is usually complete within 90 minutes.
Pain control. Cramping is expected after UFE, so a pain-control plan is part of the day. Some centers add a nerve block: in a 2018 randomized trial of 44 women, a superior hypogastric nerve block roughly halved the opioid medicine needed in the recovery room.
Going home. ACOG notes that UFE can be done as an outpatient procedure in most cases. Some women go home the same day, and others stay overnight, mainly for pain control. You may need to lie flat for a few hours afterward.

UFE recovery timeline, day by day

Recovery from UFE is shorter than from surgery, but it is not nothing. Expect a few hard days, then a steady climb. This timeline reflects published guidance and trial results. Your own recovery may be faster or slower.

When	What is typical
Day of the procedure	Cramping pelvic pain is expected and is treated with medicine. You rest, either at home or overnight, depending on how your procedure is set up.
Days 1 to 3	Cramps, tiredness and sometimes nausea, low fever and poor appetite. The CIRSE 2015 guideline calls this post-embolization syndrome and places it in the first few days. It is treated with medicine.
Days 4 to 7	RadiologyInfo describes pelvic cramps for several days after UFE, so for many women this is when the worst of the pain starts to settle.
Weeks 1 to 2	RadiologyInfo says most women return to normal activities within 1 to 2 weeks. ACOG says cramps can last up to 2 weeks. In the FIRSTT trial, the median time off work was 8 days.
Weeks 2 to 6	Most women are back at work. In EMMY, the average return to paid work was about 28 days after UFE, compared with about 63 days after hysterectomy. The CIRSE 2015 guideline gives 4 to 6 weeks as an upper bound for nearly everyone.
Months 2 to 3	Periods often become lighter. ACOG says it may take 2 to 3 months to notice a change in symptoms.
Months 3 to 12	Fibroids keep shrinking. The full effect is usually seen by about six months, and shrinkage can continue for a year or more. Ask your doctor when your follow-up visit will be and whether it includes imaging.

RadiologyInfo notes that about 2% to 3% of patients pass small pieces of fibroid tissue, which occasionally needs a minor procedure to remove. Our UFE recovery timeline has practical tips for each stage, including when to return to exercise, and our guide to post-embolization syndrome explains what is normal in the first week.

When to call right away

Pelvic pain and a low fever are expected after UFE. ACOG advises calling your doctor if you have:

Pain so severe that medicine does not help
A fever higher than 101°F
Nausea or vomiting
Bleeding or pain where the catheter was inserted
A change in color or temperature of either leg

Risks and possible complications

Serious problems after UFE are uncommon, but every procedure has risks, and you should know them before you decide. The CIRSE 2015 guideline summarizes the research this way:

Major complications occur in up to 5% of women during the procedure or in the first month.
The most common recorded complications in randomized trials were vaginal discharge and fever (about 4%), technical failure (about 4%) and post-embolization syndrome severe enough to be recorded as a complication (about 3%).
Fibroid tissue can pass through the cervix weeks or months later, and this occasionally needs a procedure in about 5% of cases. Serious infection occurs in about 2.5%.
Blood clots in the legs or lungs occur in less than 1%.
Periods stop in about 4% of women, and do not come back in less than 2%. The risk of early menopause is higher over age 45.
Deaths after UFE are extremely rare.

The 2014 Cochrane review found that minor complications were more common after UFE than after surgery, while major complications showed no clear difference, and that women were much less likely to need a blood transfusion with UFE. In the REST trial, adverse events over five years were 19% after UFE vs 25% after surgery. Our article on UFE risks and complications explains each one, how often it happens and how it is treated.

Insurance and cost in New York

Because UFE is an established treatment, it is generally covered when fibroids cause symptoms, which is very different from newer embolization procedures. Coverage depends on your plan, though, so it is worth understanding how approval works.

Commercial plans. Aetna's policy considers UFE medically necessary as an alternative to hysterectomy or myomectomy when fibroids cause persistent symptoms such as heavy bleeding, pelvic pain or pressure, urinary symptoms or pain during sex. UnitedHealthcare's 2026 commercial policy addresses UFE (CPT code 37243) and refers to standard medical-necessity criteria.
Documentation matters. Plans typically want records of your symptoms, imaging and gynecologic evaluation. In one New York external appeal, a Medicaid managed care plan's denial was upheld because there was no record of a recent normal Pap test, so a complete workup protects your approval.
If you are denied. In New York, after your plan's internal appeal you can request an external appeal through the Department of Financial Services within 4 months of the final denial. The fee is $25 per appeal (waived for Medicaid enrollees and for hardship) and is refunded if the denial is overturned.

Before treatment, ask our office to check your specific benefits and whether your plan needs prior authorization. Our article on whether UFE is covered by insurance goes through commercial plans, Medicare and Medicaid, appeals and self-pay questions, and our insurance coverage guide explains how we handle benefits for all our procedures.

Why patients choose Fox Vein Care for UFE

A vascular surgeon who performs the procedure himself. Dr. Fox is a board-certified vascular surgeon (FACS, RPVI). The doctor you meet at your consultation is the doctor who performs your UFE.
A discussion of every option. We explain medication, myomectomy, hysterectomy, radiofrequency ablation and focused ultrasound, including options we do not perform, and we tell you when another treatment is likely to suit you better.
Coordination with your gynecologist. We work with your gynecologist on the diagnosis, imaging and follow-up, so your care stays connected.
Evidence you can check. Every number on this page comes from a published study or guideline listed in the sources below.
An East Side location. Our office is on Third Avenue near 61st Street, a short walk from two subway stations.

Many women also deal with leg symptoms such as varicose veins or swelling. If that is you, our page on vein treatment for women may help as well.

Visiting our Manhattan office

Fox Vein & Vascular is at 1041 Third Avenue, New York, NY 10065, on the east side of Third Avenue between East 61st and East 62nd Streets, on the Upper East Side in the Lenox Hill area.

Lexington Av/59 St station (4, 5, 6, N, R and W trains): about a block west and two blocks south of the office.
Lexington Av/63 St station: M and Q trains on weekdays. The F stops here on weekends and late nights.
Patients from nearby East Side neighborhoods can walk or take a short ride along Third Avenue.

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Please call (212) 362-3470 for current office hours, and plan for someone to take you home on the day of your procedure.

If you already have an MRI or ultrasound report, bring it to your consultation or ask us whether we can look it over before your visit, so we can tell you whether UFE is likely to be an option for you.

Frequently Asked Questions

Is UFE the same as UAE?

Yes. Uterine fibroid embolization (UFE) and uterine artery embolization (UAE) are two names for the same procedure. Guidelines and gynecology papers usually say UAE, while patient materials often say UFE.

Do I keep my uterus after UFE?

Yes. UFE treats fibroids by blocking their blood supply, and the uterus stays in place. ACOG's 2021 practice bulletin recommends UAE for patients who want to keep the uterus, with counseling about the limited data on pregnancy afterward.

Does UFE remove the fibroids?

No. UFE cuts off the fibroids' blood supply so they shrink and soften over several months. In the EMMY trial, the largest fibroid shrank by about 61% at two years; some fibroid tissue that sits against the lining may pass out through the cervix.

How long is recovery after UFE?

RadiologyInfo says most women return to normal activities within 1 to 2 weeks. In the EMMY trial, women returned to paid work after about 28 days on average, compared with about 63 days after hysterectomy, and the CIRSE 2015 guideline gives 4 to 6 weeks as an upper bound.

Is UFE painful?

The procedure is usually done with sedation and local anesthesia, so you should be comfortable during it. Cramping afterward is expected and is treated with medicine; ACOG says abdominal pain and cramps can last up to 2 weeks.

Can I get pregnant after UFE?

Pregnancies after UFE do happen, but the evidence is limited, and a 2008 randomized trial found more pregnancies after myomectomy in the first two years. If pregnancy is your priority, myomectomy is usually the first option to discuss with your gynecologist.

Will UFE put me into menopause?

For most women, no. The CIRSE 2015 guideline reports periods stopping in about 4% of women, and the risk of early menopause is higher over age 45.

Can fibroids come back after UFE?

Symptoms can return, and more women need another procedure after UFE than after surgery. In the REST trial, 32% of UFE patients needed another procedure within five years, and in EMMY 35% had a hysterectomy within ten years, so about two in three avoided it.

Can UFE treat large fibroids?

Often, yes. In a 2010 study of 71 women with a fibroid over 10 cm or a very large uterus, there were no serious complications and 14% needed a hysterectomy over about four years. Your MRI decides whether UFE suits your fibroids.

Is UFE covered by insurance in New York?

UFE is an established treatment and is generally covered when fibroids cause symptoms; Aetna, for example, considers it medically necessary for persistent fibroid symptoms. Plans usually want records of your symptoms and imaging, so ask us to check your benefits and any prior authorization first.

Why would a vascular surgeon perform UFE?

UFE is a catheter procedure inside the arteries, which is the core of a vascular surgeon's work. Most UFEs in the US are done by interventional radiologists, but vascular surgery-based programs have also published good results.

Do I need a referral for UFE?

Whether you need a referral depends on your insurance plan, so check with your insurer. You will also need a gynecologic evaluation and imaging, usually an MRI, before UFE, and we can talk you through what to bring.

Keep Reading

Sources

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.