Hormone therapy for intramural myoma-related infertility from ulipristal acetate to GnRH antagonist: a review

Donnez, Jacques; Dolmans, Marie-Madeleine

doi:10.1016/j.rbmo.2020.05.017

Cited by 37 publications

(87 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among existing medical therapies, tranexamic acid, combined oral contraceptives, oral and injectable progestogens, progestogen-releasing intra uterine systems, antiprogesterone, gonadotropin-releasing hormone (GnRH) agonists and antagonists, selective progesterone receptor modulators (SPRMs), selective estrogen receptor modulators (SERMs), aromatase inhibitors, danazol and gestrinone are frequently cited [2,3,6,7].…”

Section: Existing Therapeutic Approachmentioning

confidence: 99%

See 1 more Smart Citation

Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Donnez

2020

JCM

Self Cite

View full text Add to dashboard Cite

Background: The objective of this review is to determine the evidence or, conversely, the absence of evidence regarding the effectiveness of progestogens in treating premenopausal women with uterine fibroids. In particular, the goal is to address recurring questions as to whether they are effective or not for managing symptoms commonly attributed to fibroids. Methods: A review of the most relevant papers (n = 63) on the efficacy of progesterone and progestogens as medical therapy for uterine fibroids. Results: Having reviewed the most significant papers on the relationship between uterine fibroids and progesterone/progestogens, it is clear that there is biochemical, histological and clinical evidence that progesterone and progestogens play a critical role in the pathogenesis of myomas. Conclusion: Since progesterone is already implicated in the pathogenesis of this entity, using progestogens to manage fibroids is like constantly adding fuel to the fire, rendering this treatment ineffective.

show abstract

Section: Existing Therapeutic Approachmentioning

confidence: 99%

“…While some fibroids are asymptomatic, others result in symptoms that warrant therapy [3,6]. The most common symptom is heavy menstrual bleeding (HMB), but pelvic pain, bulk symptoms and infertility are other frequent manifestations that may greatly affect the quality of life of these women [2,4,6,7].…”

Section: Introductionmentioning

confidence: 99%

Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Donnez

2020

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…Все эти наблюдения подтверждают важную роль эстрогенов в патогенезе ММ. Отмечено также, что терапия агонистом гонадотропин-рилизинг-гормона (аГнрГ), значительно снижающая овариальный синтез эстрогенов, приводит к достоверному уменьшению размеров опухоли [6,11].…”

Section: роль половых гормонов в развитии миомы маткиunclassified

“…В настоящее время актуальной проблемой представляется разработка тактики ведения пациенток с ММ, планирующих беременность и имеющих нарушения репродуктивной функции (бесплодие, невынашивание). Считают, что ММ может быть ассоциирована с бесплодием в 5-10 % случаев [6]. Кроме этого, ММ может быть причиной значимых акушерских осложнений: преждевременных родов, неправильного положения плода, аномалий расположения плаценты, аномалий сократительной деятельности матки.…”

Section: Introductionunclassified

“…Известно, что наряду с консервативными методами терапии ММ, которые в ряде случаев оказываются малоэффективными [6], хирургическое лечение ММ остается ведущим. Единственным способом хирургического лечения, приводящим к полному излечению, является операция в объеме тотальной гистерэктомии; миомэктомию рассматривают в качестве наиболее актуальной операции у женщин репродуктивного возраста, заинтересованных в реализации репродуктивной функции [7].…”

Section: Introductionunclassified

See 1 more Smart Citation

Uterine fibroids: the role of signaling pathways in the pathogenesis. A literature review

et al. 2020

View full text Add to dashboard Cite

Uterine fibroids are one of the most common benign tumors of the female reproductive system, originating from smooth muscle cells of the cervix or uterine body. The controversial issues of the pathogenesis of the disease make equal the various theories of its development and approaches to therapy. To date, there is no single and unambiguous opinion on the causes of the onset and recurrence of uterine fibroids, but thanks to the modern level of molecular medicine, much progress has been made in the study of hormonal and molecular genetic mechanisms of the initiation, formation and growth of the myoma node. The aim of this work was to review the modern aspects of the pathogenesis of uterine fibroids. We analyzed book chapters, original and review articles deposited in the PubMed database and related to the study of the pathogenesis of uterine fibroids from 2000 to 2019. This review presents modern data on the role of sex steroid hormones and their enzyme regulation, as well as growth factors and vitamin D in the pathogenesis of the disease. Particular attention was paid to signaling pathways involved in the regulation of basic cellular processes, in the onset and progression of the disease. It was noted that the activation of signaling pathways such as Wnt / -catenin, MAPK / ERK, and TGF- / SMAD plays a significant role in the development of uterine fibroids. Further study of the pathogenesis of the disease is needed for new strategies to design targeted therapy of uterine leiomyoma.

show abstract

Impact of FIGO type 3 uterine fibroids on in vitro fertilization outcomes: A systematic review and meta‐analysis

Favilli

Etrusco

Chiàntera

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundThe effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain.ObjectivesTo evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic review and meta‐analysis (CRD42022379700).Search strategyElectronic databases were searched until November 15, 2022.Selection criteriaStudies evaluating the effects of FIGO type 3 myomas on IVF outcome.Data collection and analysisPooled results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using Higgins I2. Sources of heterogeneity were explored with sensitivity and subgroup analyses.Main resultsIn total, 1020 patients were included: 324 with FIGO type 3 myomas and 696 controls (without myomas). A pooled data analysis showed a significantly lower live birth rate (OR 2.16, 95% CI 1.55–3.01, I2 = 0%, P < 0.00001), clinical pregnancy rate (OR 2.06, 95% CI 1.52–2.81, I2 = 0%, P < 0.00001), and implantation rate (OR 1.77, 95% CI 1.35–2.32, I2 = 0%, P < 0.00001) in women with untreated myomas compared with controls. The number and size of fibroids correlated with a worsening of IVF outcomes.ConclusionsFIGO type 3 myomas are significantly associated with a lower implantation rate, cumulative pregnancy rate, and live birth rate. Furthermore, their deleterious effect on the outcome of IVF increases further with increasing size and number. Nevertheless, no firm conclusions could be drawn about the potential benefits of surgery for FIGO type 3 uterine fibroids on IVF outcomes.

show abstract

Hormone therapy for intramural myoma-related infertility from ulipristal acetate to GnRH antagonist: a review

Cited by 37 publications

References 108 publications

Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Uterine fibroids: the role of signaling pathways in the pathogenesis. A literature review

Impact of FIGO type 3 uterine fibroids on in vitro fertilization outcomes: A systematic review and meta‐analysis

Contact Info

Product

Resources

About