Spontaneous pregnancy during ulipristal acetate treatment of giant uterine leiomyoma

Abstract

SummaryWhat is known and objective: Ulipristal acetate, a progesterone receptor modulator, pharmacologically inhibits endometrial proliferation and thereby prevents pregnancy.It is primarily used as emergency contraception, but also for the treatment of fibroids in women of reproductive age. There have been no published cases of pregnancy, while on therapy with ulipristal acetate. Case description:In this article, we present a case report of spontaneous pregnancy during ulipristal acetate therapy.What is new and conclusion: To our knowledge, this is the first patient with spontaneous conception, while on ulipristal acetate treatment. There were no drug-related complications, and the pregnancy resulted in the delivery of a healthy baby. K E Y W O R D Scontraceptive agents, leiomyoma, pregnancy outcome | WHAT IS KNOWN AND OBJECTIVEUlipristal acetate (UPA) is a new selective progesterone receptor modulator (SPRM), an antiprogestogen originally intended for contraception, mainly as emergency contraception. With time, the use of UPA has been expanded, primarily for the treatment of fibroids in women of reproductive age, where the effect is achieved by reducing the fibroid volume and bleeding, but it has also been used to treat endometriosis.1 The main mechanism in emergency contraception is the antiprogestin effect which inhibits endometrial proliferation, making a spontaneous pregnancy highly unlikely.

Ulipristal acetate for the management of large uterine fibroids associated with heavy bleeding: a review

“…Since these two papers published in 2014, unpublished data (abstracts from data congresses, symposia) report more than 100 pregnancies after UPA use and, to date, no maternal complications and/or fetal anomalies have been detected. A recent publication (Hrgovic et al, 2018) describes a patient who conceived spontaneously while on UPA. She encountered no drug-related complications and the pregnancy resulted in the birth of a healthy baby.…”