Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors

Autor: Olivier Limot, Laurence Bussierres, Vanessa Kahn, Jean Pierre Pelage, Antoine Torre, Arnaud Fauconnier
Přispěvatelé: Gamètes, implantation, gestation (GIG), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France., CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Service de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, 46 Rue Henri Huchard, 75018, Paris, France., AP-HP - Hôpital Bichat - Claude Bernard [Paris], Service de Radiologie, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France., CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), EA7404, Gamètes, Implantation, Gestation, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France., UFR des sciences de la santé, Hôpital de Poissy Saint Germain en Laye, EA7285, Risques cliniques et sécurité en santé des femmes et en santé périnatale, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France., CIC - Mère Enfant Necker Cochin Paris Centre ( CIC 1419 ), CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], Service de Gynécologie Obstétrique [Hôpital Bichat Claude Bernard], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Adult
Infertility
medicine.medical_specialty
genetic structures
medicine.medical_treatment
media_common.quotation_subject
[SDV]Life Sciences [q-bio]
Fertility
Risk Assessment
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Uterine artery embolization
Pregnancy
Surveys and Questionnaires
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Neuroradiology
media_common
030219 obstetrics & reproductive medicine
integumentary system
medicine.diagnostic_test
[ SDV ] Life Sciences [q-bio]
Leiomyoma
business.industry
Obstetrics
Interventional radiology
Leiomyoma
Epithelioid
General Medicine
medicine.disease
3. Good health
Clinical trial
Treatment Outcome
Uterine Neoplasms
Symptoms
Quality of Life
Female
France
Radiology
business
Follow-Up Studies
Zdroj: European Radiology
European Radiology, Springer Verlag, 2017, 27 (7), pp.2850-2859. ⟨10.1007/s00330-016-4681-z⟩
European Radiology, Springer Verlag, 2017, 27 (7), pp.2850-2859. 〈10.1007/s00330-016-4681-z〉
ISSN: 0938-7994
1432-1084
DOI: 10.1007/s00330-016-4681-z⟩
Popis: To evaluate the fertility of women eligible for surgical multiple myomectomy, but who carefully elected a fertility-sparing uterine artery embolization (UAE).Non-comparative open-label trial, on women ≤40 years, presenting with multiple symptomatic fibroids (at least 3, ≥3 cm), immediate pregnancy wish, and no associated infertility factor. Women had a bilateral limited UAE using tris-acryl gelatin microspheres ≥500 μm. Fertility, ovarian reserve, uterus and fibroid sizes, and quality of life questionnaires (UFS-QoL) were prospectively followed.Fifteen patients, aged 34.8 years (95%CI 32.2-37.5, median 36.0, q1-q3 29.4-39.5) were included from November 2008 to May 2012. During the year following UAE, 9 women actively attempting to conceive experienced 5 live-births (intention-to-treat fertility rate 33.3%, 95%CI 11.8%-61.6%). Markers of ovarian reserve remained stable. The symptoms score was reduced by 66% (95%CI 48%-85%) and the quality of life score was improved by 112% (95%CI 21%-204%). Uterine volume was reduced by 38% (95%CI 24%-52%). Women were followed for 43.1 months (95%CI 32.4-53.9), 10 live-births occurred in 8 patients, and 5 patients required secondary surgeries for fibroids.Women without associated infertility factors demonstrated an encouraging capacity to deliver after UAE. Further randomized controlled trials comparing UAE and myomectomy are warranted.• Women without infertility factors showed an encouraging delivery rate after UAE. • For women choosing UAE over abdominal myomectomy, childbearing may not be impaired. • Data are insufficient to definitively recommend UAE as comparable to myomectomy. • Further randomized trials comparing fertility after UAE or myomectomy are warranted.
Databáze: OpenAIRE
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