Finally read #FEMMEtrial. Is 8 point QoL difference clinically meaningful? So similar (good) outcomes for UFE and Myomectomy. Menses scores same so ?small myo benefit driven by bulk Sx (would maybe make sense) Table S3 suggests bigger / more fibroids increases myo benefit 1/4

Fertility same (underpowered) but hormones same also so probably no difference. Complications similar (NB: ITT vs PP analysis) More 2ry intervention with UAE. No HE analysis. 2/4.

Conclusion: little to choose. Both good. Bulk Sx ??better with myo. Still not enough to recommend UAE as 1ry treatment for sub-fertility alone. Gynae and #IRad should work to ensure all women with fibroids are able to access all options, including Hx, myo, #UFE, medical etc. 3/4

I think it (and the editorial) are balanced. Absent HE data, offering all the options causes no harm. Time for joint fibroid clinics for shared decision making? 4/4 @BSIR_News @SIRspecialists @RCObsGyn #fibroids #myomecomy #patientchoice