Successful pregnancy after transient ovarian failure following treatment of symptomatic leiomyomata

Kovács, Péter; Stangel, John J.; Santoro, Nanette; Lieman, Harry

doi:10.1016/s0015-0282(02)03091-1

Cited by 19 publications

(12 citation statements)

References 28 publications

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“…Clinical complications that can theoretically alter the fertility of women wishing to conceive also have been well documented. Uterine artery embolization can provoke ovarian ischemia (21) or ovarian lesions or failure (22-25) associated with transient or permanent amenorrhea and other symptoms of menopause (12,22,(25)(26)(27)(28)(29). Uterine ischemia has been described after UAE (22,25,[30][31][32][33][34][35], and one possible sequela of uterine ischemia and necrosis is uterine rupture, as reported by Shashoua et al (36) and De Iaco et al (37).…”

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confidence: 97%

“…However, it is still controversial whether UAE is a safe procedure for women desiring future fertility (5,6), and most centers have advocated a cautious approach in dealing with these patients. Sparse clinical data argue in favor of using UAE for women trying to conceive because some women who have had fibroid embolization have become pregnant and have had successful deliveries (4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Nevertheless, these reports of pregnancy after UAE remain anecdotal (case reports and limited clinical studies) and involve <100 pregnancies.…”

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confidence: 99%

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Fertility after bilateral uterine artery embolization in a sheep model

Laurent

Pelage

Wassef

et al. 2008

Fertility and Sterility

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confidence: 97%

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confidence: 99%

Fertility after bilateral uterine artery embolization in a sheep model

Laurent

Pelage

Wassef

et al. 2008

Fertility and Sterility

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“…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.…”

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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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“…12,115 Recent literature reports that uterine artery embolization also leads to POI by affecting ovarian vascular supply. 43,116 Hence, it was observed that almost any pelvic surgery, be it ovarian cyst removal or hysterectomy-can affect ovaries and lead to POI, by affecting vascular supply or by causing inflammation in pelvic area. 117 Studies have shown that in some cases of POI, ovarian function may return spontaneously many years after chemotherapy and/ or radiotherapy 118,119 and many successful pregnancies can also occur in such women.…”

Section: Iatrogenicmentioning

confidence: 99%

Premature Ovarian Insufficiency: Aetiology and Long-Term Consequences

Kumar¹,

Manesh²

2017

Women Health Open J

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Premature ovarian insufficiency (POI) is characterised by premature cessation of ovulation/ menstruation for 4-6 months along with raised serum gonadotropin levels especially follicle stimulating hormone (FSH) (>40 IU/L) on two or more occasions >4 weeks apart. POI is a heterogeneous disorder resulting from various autoimmune, iatrogenic and metabolic factors, chromosomal or genetic mutations and infections. Premature loss of ovarian function in women with POI is associated with long-term psychosocial sequelae, infertility and major health complications. It is also associated with age-specific increase in mortality due to cardio-vascular diseases. Its occurrence has increased in recent years as more and more women now-a-days attain motherhood late, also there is increase in incidence of gynaecological malignancies and its successful management leading to increased risk of POI. This manuscript aims to highlight the recent advances in pathogenesis and management of POI. Literature regarding premature ovarian insufficiency, its incidence, pathogenesis, management and recent advances was searched from various English language journals, WHO, ACOG data, published peer-reviewed articles on PubMed, Medline, Embase and Google Scholar upto 2017.

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Successful pregnancy after transient ovarian failure following treatment of symptomatic leiomyomata

Cited by 19 publications

References 28 publications

Fertility after bilateral uterine artery embolization in a sheep model

Fertility after bilateral uterine artery embolization in a sheep model

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

Premature Ovarian Insufficiency: Aetiology and Long-Term Consequences

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