Successful full-term pregnancy after bilateral uterine artery embolization for a large intracavitary submucosal fibroid: A case report

Uterine artery embolization is an established treatment for symptomatic fibroids, yet concerns persist regarding reproductive outcomes, particularly with intracavitary submucosal lesions. The current report describes the case of a 31-year-old woman who presented with severe menorrhagia and transfusion-dependent anemia. Investigations, including pelvic magnetic resonance imaging (MRI), demonstrated a large intracavitary submucosal fibroid completely occupying the endometrial cavity. She underwent an uncomplicated bilateral uterine artery embolization using polyvinyl alcohol particles, achieving near stasis on the left side and complete stasis on the right. Sixteen months later, she achieved spontaneous conception and experienced an uncomplicated antenatal course and healthy full-term delivery. No evidence of fibroid expulsion, infection, sepsis, or obstetric morbidity was observed. This case suggests that favorable reproductive and obstetric outcomes may be achievable after uterine artery embolization even for large intracavitary fibroids. It contributes to the growing evidence supporting uterine artery embolization as an alternative for women seeking fertility preservation in cases with similar characteristics. • In the reported case a large intracavitary submucosal fibroid was treated with bilateral uterine artery embolization (UAE) using polyvinyl alcohol particles. • Spontaneous conception was achieved following UAE for the cavity-distorting lesion. • No fibroid expulsion, infection, or obstetric complication was observed. • UAE may preserve fertility in selected women with an intracavitary submucosal fibroids.