The Value of Utero-Ovarian Anastomosis in Uterine Artery Embolization is Still Controversial

  • Zhen-bo OuYangEmail author
  • Jia-wen Wu
  • Zuo-fu Tian
Letter to the Editor

To the Editor,

I read the paper by Sheikh et al. [1] regarding the angiographic detection of utero-ovarian anastomosis (UOA) and influence on ovarian function after uterine artery embolization (UAE) with great interest. The study found that UOA is more common than previously expected and patients with type Ib and type III anastomoses carry the risk of ovarian failure after UAE. Protective coiling seems to be an adequate strategy for avoiding ovarian failure in those types of anastomoses.

However, as far as we know, this conclusion still needs to be testified. The rate of UOA that can be displayed in this study was 97%, which is much higher than previous reports. In fact, many corpse studies have confirmed that UOA is 100% present [2, 3]. But unlike cadaveric studies, UOA is also affected by a variety of factors such as hemodynamics and contrast agent injection pressure during uterine angiography in vivo, which is the main reason for the large difference in UOA display rates in various...



This work was supported by a grant from the Medical Science and Technology Research Fund of Guangdong (NO. A2016185).

Compliance with Ethical Standard

Conflict of interest

The authors declare that they have no conflict of interests.


  1. 1.
    Sheikh GT, Najafi A, Cunier M, Hess TH, Binkert CA. Angiographic detection of utero-ovarian anastomosis and influence on ovarian function after uterine artery embolization. Cardiovasc Intervent Radiol. 2019. ahead of print).CrossRefPubMedGoogle Scholar
  2. 2.
    Ouyang Z, Liu P, Yu Y, Chen C, Song X, Liang B, et al. Role of ovarian artery-to-uterine artery anastomoses in uterine artery embolization: initial anatomic and radiologic studies. Surg Radiol Anat. 2012;34(8):737–41.CrossRefGoogle Scholar
  3. 3.
    Kozik W. Arterial vasculature of ovaries in women of various ages in light of anatomic, radiologic and microangiographic examinations. Ann Acad Med Stetin. 2000;46:25–34.PubMedGoogle Scholar
  4. 4.
    Lanciego C, Diaz-Plaza I, Ciampi JJ, Cuena-Boy R, Rodríguez-Martín N, Maldonado MD, et al. Utero-ovarian anastomoses and their influence on uterine fibroid embolization. J Vasc Interv Radiol. 2012;23(5):595–601.CrossRefGoogle Scholar
  5. 5.
    Ouyang ZB, Quan S. Regarding, “anti-Müllerian hormone levels before and after uterine artery embolization”. Minim Invasive Ther Allied Technol. 2018;27(6):373–4.CrossRefGoogle Scholar
  6. 6.
    Lew R. Natural history of ovarian function including assessment of ovarian reserve and premature ovarian failure. Best Pract Res Clin Obstet Gynaecol. 2019;55:2–13.CrossRefGoogle Scholar
  7. 7.
    Kim CW, Shim HS, Jang H, Song YG. The effects of uterine artery embolization on ovarian reserve. Eur J Obstet Gynecol Reprod Biol. 2016;206:172–6.CrossRefGoogle Scholar
  8. 8.
    Keung JJ, Spies JB, Caridi TM. Uterine artery embolization: a review of current concepts. Best Pract Res Clin Obstet Gynaecol. 2018;46:66–73.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of GynecologyGuangdong Second Provincial General HospitalGuangzhouPeople’s Republic of China
  2. 2.Department of Interventional RadiographyGuangdong Second Provincial General HospitalGuangzhouPeople’s Republic of China

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