Am I a good candidate for UFE?

Ask whether your type, size, and location of fibroids are likely to respond to UFE. UFE is meant for symptomatic fibroids. RCOG lists asymptomatic fibroids and pregnancy among the reasons not to do it.

Will I have an MRI before treatment, and who will review it?

You will have an MRI or ultrasound to see whether you are a candidate. RCOG recommends an MRI before treatment and notes that the MRI changed the plan for up to 22% of patients. SIR's quality guideline covers imaging before treatment.

What are my other options, and how do they compare?

These include medicine, myomectomy, hysterectomy, endometrial ablation, and focused ultrasound. RCOG says UFE should be weighed alongside surgery, ablation, medical treatment, and watchful waiting. RadiologyInfo describes UFE, MRI-guided focused ultrasound, and surgery.

How many UFE procedures do you do, and who will care for me afterward?

RCOG says UFE should be done only by trained radiologists with established embolization skills, with a named doctor responsible for your care.

What is the pain plan, during the procedure and at home?

Cramping pain can be severe for several hours, and CIRSE describes a pump you can press to give yourself pain medicine. You may have pain and cramps for up to 2 weeks.

Will you go in through my groin or my wrist?

Either the groin artery or the wrist artery can be used.

What are the main risks for me?

These include bleeding, bruising, infection, injury to an artery or the uterus, passing fibroid tissue, and, rarely, a cancer that was mistaken for a fibroid and diagnosed late. Urgent hysterectomy because of infection happens in about 1%.

Could UFE bring on early menopause?

This happens in about 1–5% of patients, mostly in those over 45. Read UFE and menopause and talk with your doctor.

I may want to get pregnant. Is UFE right for me?

Guidelines describe UAE fertility effects as incompletely understood. UAE is also associated with a higher risk of miscarriage in some analyses. Read fertility after fibroid treatment and talk with your doctor.

When will I see my symptoms improve?

Changes can take 2–3 months, and fibroids may keep shrinking for a year or more.

What follow-up visits and scans will I have?

Follow-up is often at about 4–6 weeks, with a possible MRI or ultrasound at 6–9 months. RCOG advises at least one follow-up visit at 6 months.

How likely is it that I will need another procedure?

A Cochrane systematic review found that people who had UFE were more likely than people who had surgery to need a further procedure within 2 years, and 32 in 100 UFE patients needed further treatment within 5 years in the REST trial. The risk is higher in younger patients: about 25% by 5 years under age 40, vs 10% at ages 40–50. Read UFE success and regrowth for more on what success can mean.

What warning signs mean I should call you, and what number do I call?

ACOG's list: Call your care team if pain medicine does not help your pain, or if you have nausea or vomiting, bleeding or pain where the catheter went in, or a change in the color or temperature of either leg. Many care teams ask you to call about a fever of about 101°F (38.3°C) or higher; follow the instructions you were given. If you have smelly discharge with a fever, see a doctor urgently. RCOG advises giving patients contact numbers when they leave the hospital.

Will my insurance cover UFE, and what will I pay?

Coverage still depends on plan medical-necessity rules. Read UFE insurance and cost and talk with your doctor.

Questions to Ask Before UFE

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Am I a good candidate for UFE?

Ask whether your type, size, and location of fibroids are likely to respond to UFE. UFE is meant for symptomatic fibroids. RCOG lists asymptomatic fibroids and pregnancy among the reasons not to do it^1,2.
Will I have an MRI before treatment, and who will review it?

You will have an MRI or ultrasound to see whether you are a candidate². RCOG recommends an MRI before treatment and notes that the MRI changed the plan for up to 22% of patients¹. SIR's quality guideline covers imaging before treatment³.
What are my other options, and how do they compare?

These include medicine, myomectomy, hysterectomy, endometrial ablation, and focused ultrasound. RCOG says UFE should be weighed alongside surgery, ablation, medical treatment, and watchful waiting¹. RadiologyInfo describes UFE, MRI-guided focused ultrasound, and surgery².
How many UFE procedures do you do, and who will care for me afterward?

RCOG says UFE should be done only by trained radiologists with established embolization skills, with a named doctor responsible for your care¹.
What is the pain plan, during the procedure and at home?

Cramping pain can be severe for several hours, and CIRSE describes a pump you can press to give yourself pain medicine⁴. You may have pain and cramps for up to 2 weeks⁵.
Will I go home the same day or stay overnight?

Both are common^2,5.
Will you go in through my groin or my wrist?

Either the groin artery or the wrist artery can be used^2,4.
What are the main risks for me?

These include bleeding, bruising, infection, injury to an artery or the uterus, passing fibroid tissue, and, rarely, a cancer that was mistaken for a fibroid and diagnosed late⁵. Urgent hysterectomy because of infection happens in about 1%¹.
Could UFE bring on early menopause?

This happens in about 1–5% of patients, mostly in those over 45^1,2,4. Read UFE and menopause and talk with your doctor.
I may want to get pregnant. Is UFE right for me?

Guidelines describe UAE fertility effects as incompletely understood^6,7. UAE is also associated with a higher risk of miscarriage in some analyses⁸. Read fertility after fibroid treatment and talk with your doctor.
When will I see my symptoms improve?

Changes can take 2–3 months, and fibroids may keep shrinking for a year or more⁵.
What follow-up visits and scans will I have?

Follow-up is often at about 4–6 weeks, with a possible MRI or ultrasound at 6–9 months⁴. RCOG advises at least one follow-up visit at 6 months¹.
How likely is it that I will need another procedure?

A Cochrane systematic review found that people who had UFE were more likely than people who had surgery to need a further procedure within 2 years⁹, and 32 in 100 UFE patients needed further treatment within 5 years in the REST trial¹⁰. The risk is higher in younger patients: about 25% by 5 years under age 40, vs 10% at ages 40–50¹. Read UFE success and regrowth for more on what success can mean.
What warning signs mean I should call you, and what number do I call?

ACOG's list: Call your care team if pain medicine does not help your pain, or if you have nausea or vomiting, bleeding or pain where the catheter went in, or a change in the color or temperature of either leg⁵. Many care teams ask you to call about a fever of about 101°F (38.3°C) or higher; follow the instructions you were given⁵. If you have smelly discharge with a fever, see a doctor urgently⁴. RCOG advises giving patients contact numbers when they leave the hospital¹.
Will my insurance cover UFE, and what will I pay?

Coverage still depends on plan medical-necessity rules. Read UFE insurance and cost and talk with your doctor.

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Select the topics that apply to your upcoming non-urgent visit and get a personalized question checklist to bring to your clinician. Talk with your doctor about these questions.

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Questions to ask before UFE