Medical Management of Uterine Fibroids

Parsanezhad, Mohammad Ebrahim; Jahromi, Bahia Namavar

doi:10.1007/s13669-012-0008-5

Cited by 4 publications

(6 citation statements)

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“…This finding may be in accordance with that of previous studies which pointed out that high E2 could impair embryonic cleavage (24). The morphology and cleaving status are used to evaluate embryo developmental potential before uterine transfer (10). Embryos were graded into three grades depending on morphological criteria (blastomeres number, blastomeres regularity and fragmentation rate).…”

Section: Discussionmentioning

confidence: 99%

“…The introduced GnRH antagonist, Cetrorelix, has been shown to be efficient in preventing the LH rise during stimulation in IVF protocols (8) A successful in vitro fertilization (IVF) program can be achieved through an accurate embryo quality evaluation (9). In most IVF clinics around the world, this quality assessment depends mainly on the morphologi-cal evaluation of cleavage stage embryos before embryo transfer which is correlated to implantation potential of each particular embryo and pregnancy rate after IVF (10). For this purpose many classification systems developed (11).…”

Section: Introductionmentioning

confidence: 99%

“…One of suggested grading system which depends on morphological criteria of cleaving embryo is classified as follows (with grade 1 representing the best morphological condition): -Grade I: Symmetrical blastomeres and no fragmentation -Grade II: Even or uneven blastomeres and 10-20% fragmentation. -Grade III: Uneven blastomeres and> 20% fragmentation (10).…”

Section: Introductionmentioning

confidence: 99%

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2018

IJEIR

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Background:Defects in reproduction that may involve both the male & female partners result in the inability to procreate which is known as infertility. The use of assisted reproductive technologies (ART's) has been increasing over the past three decades. Many efforts have been done to compensate for unsatisfactory results in in-vitro fertilization (IVF) procedures, so that patients undergo different ovarian stimulation protocols to control retrieval of multiple oocytes in a single cycle. Although ovarian stimulation has an important role in ART's, it may also have detrimental effects on oocyte quality, embryo quality, and IVF outcomes. Objectives: To assess the effect of long agonist versus antagonist protocols on oocyte and embryo quality in IVF-Intracytoplasmic sperm injection (ICSI). Patients,Materials and Methods: This comparative study was done on the embryos of seventy one infertile females who were undergoing Intracytoplasmic sperm injection (ICSI) treatment regardless to the presence or absence of previous trials. These patients were divided into two groups, 45 of them treated with agonist protocol and other 26 patients treated with antagonist protocol. First oocyte retrieved was used for further assessment. Of the 71 oocytes, there were eight immature oocytes (3 at germinal vesicle (GV) stage, 5 at metaphase I (MI) stage) and three abnormal oocytes, and these were excluded from the following ICSI treatment. Assessment and comparison of oocyte maturity, fertilization rate, cleavage rate and resulting embryo quality were done. Results:The results of the present study showed significant difference (p<0.05) in oocyte number and maturity but no significant (p>0.05) difference between the group treated with long agonist and those on antagonist protocol regarding fertilization rate, cleavage rate, and embryo quality. Conclusions:The type of protocol used in in-vitro fertilization has no detrimental effect on oocyte or embryo quality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2018

IJEIR

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“…Gonadotropin-releasing hormone analogues (GnRHa) comprise some of the chemotherapeutic drugs currently used in fibroid treatment. However, the short half-life of these drugs is a major limitation to treatment and prolonged usage can also lead to adverse effects, such as depression, reduced breast size, and vaginal dryness 16,17 . Anastrozole and Letrozole are also used in the treatment of uterine fibroids.…”

Section: Introductionmentioning

confidence: 99%

Effects of ethanol extracts of Diodia sarmentosa leaves on biochemical and histopathological indices of monosodium glutamate-induced uterine leiomyoma in rats

Ezejiofor

Okoroafor

2022

Biomed. Res. Ther.

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Background: Diodia sarmentosa leaves have gained application in the local treatment of certain ailments. This study evaluated the effect of ethanol extracts of Diodia sarmentosa leaves on biochemical, antioxidant, and histopathological indices of monosodium glutamate-induced uterine leiomyoma in albino rats. Methods: Twenty-one (21) female adult albino rats were acclimatized for 10 days and then classified into three treatment groups, each containing seven rats. Group 1 was the normal control (NC) without any induction, Group 2 was the positive control (PC) and was induced with 200 mg/kg body weight of monosodium glutamate (MSG) without treatment, and Group 3 was the treated group (TG), induced with 200 mg/kg body weight of MSG, then treated with 400 mg/kg body weight of ethanol extract of Diodia sarmentosa leaves for 30 days. Results:The results of the study showed an impaired antioxidant system in the positive control (untreated group). Some biochemical parameters were also altered in the positive control, mostly revealing a relationship between uterine leiomyoma and renal impairment, or kidney damage. Treatment with ethanol extracts of Diodia sarmentosa leaves significantly (P < 0.05) improved the altered biochemical and antioxidant parameters. These findings were also supported by a histopathology result, which revealed the extent of tumors in the affected tissues. Conclusion: The ethanol extract of Diodia sarmentosa (Sw) leaves mitigated oxidative stress and improved the impaired antioxidant system caused by uterine leiomyoma induction.

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“…Prace dotyczące dystrybucji receptorów steroidowych w macicy wykazały większą koncentrację receptorów dla estrogenów i progesteronu w tkance mięśnia-ków niż w otaczającym endometrium [6][7][8]. Uważa się, że progesteron może mieć dwojaki wpływ na mięśniaki za pośrednictwem lokalnych czynników wzrostu.…”

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Will uterine fibroids be operated less frequently?

Jakiel¹,

Słabuszewska-Jóźwiak²,

Czekańska-Rawska³

et al. 2013

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StreszczenieMięśniaki macicy są jedną z najczęściej występujących chorób żeńskiego narządu płciowego. Mogą powodować nieprawidłowe i obfite krwawienia z dróg rodnych oraz ból w okolicy miednicy mniejszej. Dolegliwości te są główną przyczyną konsultacji ginekologicznych. Możliwości farmakologicznego leczenia mięśniaków macicy są ograniczone. Na podstawie dotychczas przeprowadzonych badań oceniono skuteczność leczenia objawów mięśniaków macicy przy zastosowaniu: progestagenów, systemu wewnątrzmacicznego uwalniającego lewonorgestrel, leków antyfibrynolitycznych, niesteroidowych leków przeciwzapalnych (NLPZ), analogów gonadoliberyny (gonadotropin-releasing hormone -GnRH) oraz selektywnych modulatorów receptora progesteronowego (selective progesterone receptor modulators -SPRM). Na rynku dostępnych jest niewiele leków, które mają zarejestrowane wskazanie terapeutyczne w leczeniu objawów mięśniaków macicy. Należą do nich analogi GnRH oraz od niedawna octan uliprystalu (SPRM). Leczenie analogami GnRH stanowiące alternatywę dla leczenia zabiegowego okazało się niezadowalające. Okres terapii nie może być dłuższy niż 6 miesięcy z powodu gwał-townej demineralizacji kości związanej ze zmniejszeniem stężenia estrogenów. Po odstawieniu analogów GnRH dochodzi do ponownego wzrostu mięśniaków, niemal do rozmiarów zbliżonych sprzed okresu leczenia, oraz do nawrotu objawów u większości kobiet.Octan uliprystalu może okazać się realną alternatywą terapeutyczną dla trudnych technicznie zabiegów miomektomii laparoskopowej czy embolizacji tętnic macicznych. Ważnym wyróżnikiem tego leku jest utrzymujący się efekt terapeutyczny oraz korzystny profil bezpieczeństwa. Wyniki przeprowadzonych dotychczas badań wskazują, że po zakończeniu leczenia u około połowy pacjentek odstąpiono od zabiegu chirurgicznego. U pacjentek w okresie obserwacji klinicznej po zaprzestaniu leczenia octanem uliprystalu utrzymała się poprawa w zakresie kontroli krwawienia, odczuwanego bólu i jakości życia.Miomektomia jest wskazana tylko w przypadku objawowych mięśniaków macicy, w zależności od ich wielkości i liczby. Może być wykonana endoskopowo lub na drodze laparotomii. Zakres i metoda leczenia powinny uwzględnić nie tylko obecność objawów klinicznych, ale także oczekiwania kobiet pragnących zachować płod-ność i poczucie kobiecości, które subiektywnie wiąże się z faktem posiadania macicy.Słowa kluczowe: mięśniaki macicy, leczenie, octan uliprystalu. SummaryUterine fibroids are one of the most common pathologies of the female reproductive system, which may cause abnormal, heavy bleeding and pelvic pain. These ailments often prompt women to consult their gynecologists. Pharmacotherapeutic options in uterine fibroids are limited. The studies conducted so far have assessed the efficacy of progestogens, levonorgestrel-releasing intrauterine systems, antifibrinolytic agents, nonsteroid anti-inflammatory drugs, GnRH analogues and Selective Progesterone Receptor Modulators (SPRMs) in the treatment of fibroid symptoms. Few agents available on the market have been approved ...

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Medical Management of Uterine Fibroids

Cited by 4 publications

References 83 publications

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Effects of ethanol extracts of Diodia sarmentosa leaves on biochemical and histopathological indices of monosodium glutamate-induced uterine leiomyoma in rats

Will uterine fibroids be operated less frequently?

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