Uterine artery embolization for fibroids does not have adverse effects on ovarian reserve in regularly cycling women younger than 40 years

Tropeano, Giovanna; Stasi, Carmine Di; Litwicka, Katarzyna; Romano, Domenico; Draisci, Gaetano; Mancuso, Stefano

doi:10.1016/j.fertnstert.2003.09.046

Cited by 95 publications

(63 citation statements)

References 41 publications

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“…Those investigators concluded that most of their patients had no change in ovarian function after UAE and that patients 45 years old or older have an approximately 15% chance of an increase in basal follicle-stimulating hormone level into the perimenopausal range. Results of a prospective study [40] in which the subjects were 20 regularly cycling women indicated no change in ovarian reserve as assessed with basal follicle-stimulating hormone and estradiol levels and ultrasound-based ovarian volume and antral follicle count as long as 12 months after UAE.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Firouznia

Ghanaati

Sanaati³

et al. 2009

American Journal of Roentgenology

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[12,13], and cervical ectopic pregnancy [14][15][16] has been reported.The effects of embolization on ovarian function are important when preservation of fertility is desired. Few articles have focused on the effect of UAE for fibroids and its outcome on future fertility and pregnancy. To the best of our knowledge, pregnancy after UAE has been described in the literature in the form of case reports [17][18][19][20], a review article [21], and retrospective reports of case series [22][23][24][25][26][27][28][29]. As of March 2008, more than 170 patients worldwide had become pregnant after UAE. At a university-affiliated referral hospital in Iran, we evaluated the pregnancies of women who underwent UAE for symptomatic fibroids and desired to become pregnant. Subjects and Methods From Wo m e n's I m ag i ng • O r ig i n a l R e s e a rc h Uterine fibroids are among the most common benign tumors of the female pelvis that cause abnormal menstrual bleeding. Uterine artery embolization (UAE) in the management of uterine myomas was first reported by Ravina et al. in 1995 [1]. Their promising results were confirmed in several uncontrolled cohort studies, which showed an approximately 50% decrease in uterine volume and relief of symptoms in 80-90% of patients [2]. The advantages of UAE include lower cost and more rapid recovery than can be achieved with conventional therapies [3][4][5]. The efficacy of uterine embolization in the management of pelvic hemorrhage has been well documented in obstetrics and gynecology [6][7][8]. Successful pregnancy outcome after embolization for obstetric hemorrhage [9,10] Please see the commentary on this article, which appears on the following pages. W O M E N ' S I M A G I N G PROOF Copyrighted Material For Review Only • Not for DistributionPage Copy OBJECTIVE. The purpose of this study was to report on pregnancies and their outcome after uterine artery embolization for uterine fibroids. SUBJECTS AND METHODS. From 2001 to 2004, 102 patients (mean age, [± SD]35.7 ± 6.4 years; range, 20-48 years) with symptomatic uterine fibroids underwent uterine artery embolization with 500-to 710-µm polyvinyl alcohol particles. The mean uterine volume was 552 ± 649 cm 3 (range, 94-4,656 cm 3 ), and the dominant fibroid size was 228 ± 359 cm 3 (range, 14-2,618 cm 3 ) before the procedure. During the 2-year follow-up period, the patients were asked whether they were trying to achieve pregnancy and whether they were successful. We obtained pregnancy and obstetric records of the pregnant women from physicians' offices and hospitals.RESULTS. Among 102 women who underwent bilateral uterine artery embolization, 23 (22.5%) were seeking to become pregnant, and 14 of the 23 (61%) became pregnant, nine having been nulliparous. One patient had two pregnancies. Fourteen pregnancies were spontaneous, and one was achieved by zygote intrafallopian transfer. Two miscarriages occurred, one in the 12th and one in the 16th week of gestation. The other 13 pregnancies went to term, were uncomplicated, and ended in elective...

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Section: Discussionmentioning

confidence: 99%

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Firouznia

Ghanaati

Sanaati³

et al. 2009

American Journal of Roentgenology

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“…Tissue hypoxia that caused by torsion may also decrease ovary reserve by leading to necrosis in ovary tissue. Plication of uteroovarian ligament may compromise minimally ovarian blood as it may interfere minor blood supply which passes through the ligament, however this may be negligible (15) . Serum Anti-Müllerian hormone (AMH) level has been suggested to be a reliable marker of ovarian reserve.…”

Section: Eventsmentioning

confidence: 99%

Surgical approaches to recurring torsions and the effects of the attacks on the ovarian reserve: a case study in light of the literature

Üçkuyu¹,

Turhan²,

Çiftçi³

et al. 2013

J Turk Soc Obstet Gynecol

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“…This complication seems to occur mainly in women > 45 years of age (Rashid et al, 2010;Tulandi et al, 2002). Transient ovarian failure has also been described (Ahmad et al, 2002;Amato & Roberts, 2001) but other studies did not show any untoward effects on ovarian function from UAE (Ahmad et al, 2002;Tropeano et al, 2004). Ovarian damage is thought to occur after UAE because of passage of embolization particles through anastomotic vessels between uterine and ovarian arteries, causing hypoxic ovarian damage and tissue loss.…”

Section: Postprocedural Carementioning

confidence: 99%

“…Ovarian reserve reduction can better be tested by measuring anti-Mullerian-hormone (AMH), a reliable marker of ovarian reserve, especially in relation to the quantity of remaining follicles in the ovaries (Hehenkamp, 2005Tropeano et al, 2004). As a result of the abundant collateral arterial circulation, normal uterine tissue usually recovers from the reduction in uterine blood flow induced by bilateral UAE.…”

Section: Postprocedural Carementioning

confidence: 99%

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Is Embolization Equal to Hysterectomy in Treating Uterine Fibroids?

Strinić¹

2012

Hysterectomy

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Uterine artery embolization for fibroids does not have adverse effects on ovarian reserve in regularly cycling women younger than 40 years

Cited by 95 publications

References 41 publications

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Surgical approaches to recurring torsions and the effects of the attacks on the ovarian reserve: a case study in light of the literature

Is Embolization Equal to Hysterectomy in Treating Uterine Fibroids?

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