If you want a pregnancy later and you have fibroids now, you have probably run into two opposite claims: that embolization ends your fertility, and that it has no effect at all.
Neither is what the research says. Here is the actual picture — what the studies measured, how good each kind of study is, and what it means for you.
First, the honest starting point
Fertility questions after any fibroid treatment are hard to study. Women who want a pregnancy are not randomly assigned to procedures — younger women with favorable anatomy are steered toward one option, older women with complicated anatomy toward another. That selection is baked into most of the published data, and it makes some comparisons look sharper than they are.
So we’ll be explicit about which kind of evidence each number comes from.
What happens to pregnancy rates after UFE
The anchor is a 2025 meta-analysis in the Journal of Clinical Medicine: 33 studies, 4,287 women who sought pregnancy after uterine artery embolization.
- About half became pregnant — a pooled pregnancy rate of 52%.
- Age dominated everything. Roughly two in three women under 30 conceived, compared with about one in three over 40.
- Mean time to conception was around 15 months.
The biggest predictor of fertility after the procedure is the same as the biggest predictor before it. Your age.
The more telling comparison in that paper is against women the same age who didn’t have the procedure. Infertility rates after embolization — 16% under 35, 29% between 35 and 40, 41% over 40 — matched the comparable age-matched populations of women with untreated fibroids.
Embolization did not add to a woman’s existing infertility risk. Whatever her odds of conceiving were with fibroids at her age, they were the same afterwards.
A separate review reached the same place from a different angle, finding pregnancy and miscarriage rates after embolization comparable to the age-matched population.
What about compared with myomectomy?
This is the comparison women actually want, and the newer evidence has largely settled it.
Pregnancy rates after embolization and after myomectomy are close to identical.
A 2024 meta-analysis in the American Journal of Obstetrics & Gynecology pooled every randomized controlled trial that has compared the two procedures head to head. Its finding on pregnancy: no difference. Randomization is what makes that comparison worth anything — it is the only design that stops the two groups being different kinds of women to begin with.
That last point deserves spelling out, because it is where older comparisons went wrong. Myomectomy is preferentially offered to younger women with more favorable anatomy — the women most likely to conceive whatever is done to them. And in the pooled non-randomized data, the myomectomy groups are several times larger than the embolization groups, so the raw split between them is measuring who got picked for each procedure at least as much as it is measuring the procedures. Compare like with like, and the gap goes away.
The question that matters more than the procedure
Before any of the above applies to you: where are your fibroids? Location affects fertility more than size or number, and more than which treatment you choose.
| Where the fibroid sits | Effect on fertility |
|---|---|
| Submucosal — bulging into the uterine cavity, where an embryo implants | The real problem. Roughly halves ongoing pregnancy rates. |
| Intramural — within the muscle wall | A moderate effect (about 37% versus 41% cumulative pregnancy in a systematic review). |
| Subserosal — on the outer surface | Little to no impact. |
This is why the first question in a fertility consultation is never “which procedure?” It’s an imaging conversation.
What we tell women who want the option open
Four things, every time:
- Tell us first. If a future pregnancy matters to you, say so at the start of the consultation, not the end. It changes what we look for on your imaging, which fibroids we prioritize, and how the procedure is planned.
- Your age is the headline. Not the procedure. Any doctor who discusses fertility after a fibroid treatment without discussing your age is skipping the main variable.
- Location decides more than the brochure does. If your fibroids are submucosal, addressing them may help your fertility regardless of the method; if they’re subserosal, they probably weren’t the obstacle.
- We won’t promise you a pregnancy. Nobody can, and the published evidence doesn’t support a promise from any option on the menu. What we can do is show you your imaging, tell you what the data supports and what it doesn’t, and say plainly if another path serves you better.
The short version
About half the women who want a pregnancy after UFE achieve one, and their outcomes match women the same age with fibroids who never had the procedure. Head to head against myomectomy in the randomized evidence, pregnancy rates are close to identical.
The variable you can’t change is your age. The variable most people never ask about is where your fibroids are. Start there.
Read the full UFE procedure page, see every fibroid treatment compared, or book a consultation and bring your imaging.
Written and reviewed by the physicians of Arthritis Relief & Vascular Centers. This article is general health education, not medical advice, and reading it does not create a doctor–patient relationship. Every case is different — talk with a physician who has seen your imaging and examined you before making a treatment decision. If you are having a medical emergency, call 911.