UFE Procedure Safety with IUD: Patient Guide

If you’re exploring options to manage fibroid symptoms (such as heavy bleeding, pain, or pressure), you may be curious about the safety of undergoing uterine fibroid embolisation (UFE) while using an intrauterine device (IUD). It’s understandable to feel uncertain with conflicting viewpoints online and among clinicians. While UFE and IUD risks remain under study, some evidence suggests that removing your IUD before the embolisation procedure isn’t always necessary for most patients. 

In the context of UFE and birth control, experts largely recommend allowing the uterus to heal after treatment before planning pregnancy, and individualised management based on your unique health history is key. This guide brings together current evidence and practical considerations regarding IUD and fibroid embolisation to help you make the best choices about symptom relief and future fertility. 

Interested in knowing more about risks to your fertility? Learn about how uterine fibroid embolisation affects fertility. It will help you discuss your IUD and UFE options safely with a specialist.

How UFE and IUD Can Work Together for Fibroid Symptom Relief

Understanding What Each Does

• UFE (Uterine Fibroid Embolisation) blocks the blood supply to fibroids so that they shrink over time. This can lead to drastic relief from symptoms such as heavy bleeding, pressure, and pain. Studies show UFE can minimise fibroid volume substantially and improves quality of life for many women.
• IUDs (Intrauterine Devices) are a form of contraceptive. Hormonal IUDs (like Mirena) release progestin that can decrease heavy bleeding related to fibroids, while copper IUDs prevent pregnancy without hormones but may not reduce bleeding and can sometimes worsen cramps. 

Symptom Relief Synergy

When a hormonal IUD is in place, particularly for patients with heavy menstrual bleeding, it can offer symptomatic relief while you consider definitive fibroid treatment. However:

• An IUD does not shrink fibroids on its own. 
• UFE targets the cause of symptoms by cutting off the fibroid blood supply and leading to shrinkage. 
• Both can coexist: several small studies and clinical experiences show that UFE can proceed safely with an IUD in place without a significant increase in infection risk, and the device doesn’t appear to interfere with the core mechanism of embolisation. 

Evidence on UFE with IUD In Situ

Medical literature on UFE with IUD is limited but growing:

• A retrospective study found that women undergoing UFE with an IUD in place did not experience an increase in infectious complications. This suggests that the presence of an IUD might not be a contraindication for the embolisation procedure. 
• Some older clinical recommendations still suggest considering IUD removal before UFE, though they also acknowledge small studies showing no extra risk when left in place, illustrating ongoing differences in practice based on clinician preference and risk tolerance. 

Practitioners mainly assess this on a case‑by‑case basis because large randomised trials are limited. Always consult with your interventional radiologist and gynecologist for personalised advice.

Real‑World Benefits of UFE (With or Without IUD)

Although not IUD‑specific, UFE case examples illustrate typical fibroid symptom outcomes:

• In clinical case series, women treated with UFE reported dramatic symptom relief, including resolution of heavy bleeding and reduction in uterine volume, allowing them to return to normal activities. 
• One woman with a Mirena IUD previously inserted for heavy bleeding continued to experience symptoms until undergoing UFE, after which her bleeding became significantly lighter and fibroids shrank markedly. 

Such cases demonstrate how UFE can complement prior symptom‑focused treatments like hormonal IUDs when fibroids are the root cause.

Comparing UFE with Myomectomy or Hysterectomy for Patients with IUD

Myomectomy or hysterectomy may require removal of an IUD prior to surgery unlike UFE. Myomectomy involves surgically removing fibroids while preserving the uterus, regularly necessitating IUD removal to minimise infection risk and allow safe uterine access. Hysterectomy removes the uterus entirely, which naturally removes any IUD. In contrast, UFE is minimally invasive, mostly allows the IUD to remain in place, and usually has shorter recovery times, making it a preferred option for symptom relief without impacting existing contraception.

Follow-Up Imaging and Recovery

Follow-up imaging After UFE, usually an ultrasound or MRI, is recommended within a few months to assess fibroid shrinkage and uterine healing. Most patients recover within 1–2 weeks for daily activities, though heavy exercise and sexual activity may be restricted for 2–4 weeks. Your clinician will provide a specialised timeline based on imaging results and symptom resolution.

Frequently Asked Questions: UFE and IUD

Is it safe to undergo UFE with an IUD in place?

In many cases, yes. Limited studies show no substantial increase in infection or complications when the IUD remains during UFE, but your clinician will evaluate your individual risk. 

Should my IUD be removed before UFE?

Some clinicians recommend removal, especially if there are related symptoms like unusual discharge or if you’re planning pregnancy soon afterward. Others may leave it in situ if there’s no sign of active infection. Decisions are individualised.

Will UFE affect my birth control?

UFE generally does not affect the contraceptive effectiveness of your IUD. However, the timing of pregnancy after UFE should be discussed with your clinician.

Can I still get pregnant after UFE?

Many women conceive successfully after UFE, though fertility outcomes vary and should be discussed with your healthcare team. Some guidelines counsel thorough fertility counseling before relying on UFE if future pregnancy is a priority. 

When can I receive a new IUD after UFE if mine was removed?

Protocols vary, but some centers advise waiting until your uterus has sufficiently healed. Your clinician will advise based on imaging and recovery.

What are the signs I should contact my doctor after UFE?

Fever, severe pain not controlled by medications, heavy bleeding, or foul‑smelling discharge are warnings that need prompt evaluation.

UFE and IUD Discussion Takeaway

UFE and IUDs can mostly coexist without increasing procedural risk, and both play roles in managing fibroid symptoms, one addressing symptoms of bleeding and contraception, the other targeting size and blood supply. Because evidence on UFE and IUD interactions is still emerging, decisions should always be personalised through conversation with your interventional radiologist and gynecologist.

Ready to discuss how UFE could help you? Book a consultation with Minima Radiology for tailored advice and next steps.