Premature Ovarian Failure After Uterine Artery Embolization

Uterine artery embolization (UAE) is popular in some countries for management of postpartum hemorrhage, uterine myoma, and adenomyosis. However, avoidance of complications is important to preserve the uterus. The most serious complication is premature ovarian failure. UAE is advantageous for preserving the uterus for fertility; however, premature ovarian failure negates this advantage by causing infertility. We report two cases of premature ovarian failure after UAE. Our cases provide guidance for gynecologists who perform UAE. The first patient, aged 42 years, was para 1-0-0-1 and did not have a significant family history. She complained of metromenorrhagia, but she wanted to preserve her uterus for fertility. We performed a bilateral UAE. After 4 months, she complained of amenorrhea. She was diagnosed with premature ovarian failure by checking follicle stimulating hormone (FSH). The second patient, aged 40 years, had infertility from uterine myoma, endometriosis, and adenomyosis. She had undergone UAE and in vitro fertilization (IVF) 6 years earlier. After IVF, she became pregnant and was admitted from 26 weeks to 29 weeks for preeclampsia and preterm labor. After delivery, she had postpartum hemorrhage, and repeat UAE was performed. Two years later, she complained of hot flashes and amenorrhea. She was diagnosed with premature ovarian failure.