Surgical treatment of fibroids for subfertility

Metwally, Mostafa; Raybould, Grace; Cheong, Ying; Horne, Andrew

doi:10.1002/14651858.cd003857.pub4

Cited by 53 publications

(57 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to many authors, laparoscopic myomectomy is an effective operation for women who are planning a pregnancy with subsequent good reproductive results regarding pregnancy outcomes and the frequency of miscarriages [8][9][10]. On the other hand, there are a number of features of the course of pregnancy in the presence of a scar on the uterus after myomectomy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of High-Intensity Focused Ultrasound Rays in the Treatment of Uterine Fibroids on Tissue Parameters of Endometrial Receptivity

Melkozerova¹

2020

WJGWH

View full text Add to dashboard Cite

Objective: To analyse the effect of the ultrasonic energy during MRI-guided high-intensity focused ultrasound ablation (HIFU) of uterine fibroids on molecular markers of endometrial receptivity in women of reproductive age. Study design:A prospective comparative cohort study of 60 women of reproductive age was conducted. The main group consisted of 32 patients suffering from the symptomatic course of uterine fibroids who received treatment with HIFU ablation of uterine fibroids: 17 women with node localization at the front wall of the uterus and the reflected action of ultrasonic waves on the endometrium and 15 women with the back wall node localization and penetrating effect of the waves. The control group consisted of 28 healthy fertile women examined voluntarily. The endometrium obtained with pipelle-biopsia on days 20-22 of the cycle was examined by immunohistochemistry before and three months after the treatment. The results were processed by the method of variation statistics using the SPSS 22.0.Results: A significant decrease in the stromal expression of CD95 bright in the endometrium to the level comparable with control values was observed after HIFU ablation of uterine fibroids (from 70.22±9.77 c/s to 48.81±5.47 c/s; p<0.001; the control level -47.80±2.13 c/s). The ratio and expression of steroid receptors, proliferation markers, p53-dependent apoptosis and itsblockers, regulators and markers of angiogenesis, LIF and LIF-R signalling molecules in thestroma and endometrial glands did not change significantly after treatment (p>0.05 in treatment dynamics).It was demonstrated that focused ultrasound causes an increase in the level of expression of estradiol alpha receptors in the endometrial glands (118.07±14.01 points vs.153.33±11.43 points; p=0.02) and a decrease in stromal p 53 expression (30.80±21.61% vs.14.66±3.74%; p=0.007). No influence of the localization of fibroid node on the stromal expression of CD56 bright+ was demonstrated. A significant increase in the stromal expression of CD34+ to the level statistically comparable with control values (from 26.00±1.63 c/s to 32.47±2.03 c/s; p=0.011; the control level -37.99±1.23 c/s) was associated with ultrasound action. Conclusion:This study did not reveal any significant negative effects of HIFU ablation of uterine fibroids on endometrial receptivity in women of reproductive age.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the presence of indications, myomectomy with careful layer-by-layer closure of the node bed is the first-line treatment method for patients with uterine fibroids planning a pregnancy [1,2,[8][9][10]. In this case, the risk of uterine rupture after laparoscopic myomectomy does not exceed 0.5 -1% [11,12].…”

Section: Introductionmentioning

confidence: 99%

The Effect of High-Intensity Focused Ultrasound Rays in the Treatment of Uterine Fibroids on Tissue Parameters of Endometrial Receptivity

Melkozerova¹

2020

WJGWH

View full text Add to dashboard Cite

show abstract

“…Bei 20-40 % aller Frauen im gebärfähigen Alter treten Myome auf [23] Eine Metaanalyse zeigte eine signifikant verminderte LGR nach ART bei intramuralen Myomen ohne submukösen Anteil [26]. Eine Cochrane-Analyse wies hingegen keine eindeutige Verbesserung der SSR nach Myomresektion auf [27]. Ebenso konnte kein Unterschied hinsichtlich der operativen Methode (LSK vs. Minilaparotomie vs. Laparotomie) festgestellt werden.…”

Section: Myomeunclassified

Bedeutung der Fertilitätschirurgie bei Kinderwunsch

Tóth

Feil

Zippl

et al. 2021

Gynäkologische Endokrinologie

View full text Add to dashboard Cite

ZusammenfassungDie Bedeutung der Fertilitätschirurgie bei Kinderwunsch kann vielfach aufgrund fehlender eigener Erfahrung während der Facharztweiterbildung nicht erfasst werden, da nur an wenigen Zentren eine spezifische operative Ausbildung erfolgt. Neben der Abklärung anatomischer Fehlbildungen mittels Hysteroskopie bzw. Laparoskopie gehört die operative Myom- und Endometriosebehandlung zu den Standardverfahren der Fertilitätschirurgie. Hier ist die Erfahrung der Reproduktionsmediziner gefragt, damit unter maximaler Schonung der Ovarreserve ein bestmöglichstes Ergebnis hinsichtlich Endometriosesanierung bzw. Myomenukleation erreicht wird. Die Abklärung der Tubendurchgängigkeit mit Chromopertubation ist nach wie vor Goldstandard, auch wenn im ambulanten Sektor vorwiegend nichtoperative Verfahren zum Einsatz kommen. Die diagnostische und gegebenenfalls operative Hysteroskopie dient der Beurteilung des Endometriums und erlaubt den Ausschluss von Entzündungsprozessen oder dem Vorliegen von Polypen.

show abstract

“…2 UF can also adversely affect fertility and birth outcomes, although these data are limited. 3 Despite the large public health burden of UF in the United States, little is known about UF natural history or pathogenesis owing to a lack of longitudinal studies with imaging to confirm UF status. However, it is well accepted that the strongest risk factor for having UF is being of Black race.…”

Section: Introductionmentioning

confidence: 99%

Black Women Are More Likely Than White Women to Schedule a Uterine-Sparing Treatment for Leiomyomas

Wegienka

Stewart

Nicholson³

et al. 2021

Journal of Women's Health

View full text Add to dashboard Cite

Background: To evaluate differences in the proportion of uterine fibroid (UF) treatments that are uterinesparing between Black women and White women and identify factors that could explain disparities. Methods: Women at age 18-54 years who were enrolled from 10 clinical sites in the United States into the Comparing Options for Management: Patient-Centered Results for UFs (COMPARE-UF) treatment registry completed questionnaires before their UF procedure. UF symptoms and quality of life were assessed by questionnaires. Details on UF imaging and treatment (hysterectomy, myomectomy, or uterine artery embolization [UAE]) were collected from each patient's medical record. Random-effects logistic regression was used to assess the association between race and the odds of having a uterine-sparing procedure versus hysterectomy. Subgroup analyses compared each uterine-sparing procedure with hysterectomy. Results: In this cohort of 1141 White women and 1196 Black women, Black women tended to be younger (median 41.0 vs. 42.0 years) and report worse symptoms, pain, and function on every scale compared with White women. Black women were more likely to have had a prior UF treatment compared with White women (22.8% vs. 14.6%). White women had more hysterectomies (43.6% vs. 32.2%) and myomectomies (50.9% vs. 50.2%) versus Black women. Black women had more UAEs (15.1% vs. 4.7%) than White women. After adjusting for clinical site and other variables, Black women had greater odds than White women of having a myomectomy (odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.63-3.56) or a UAE versus hysterectomy (OR = 4.24, 95% CI = 2.41-7.46). Conclusion: In these participants, Black women were more likely to schedule a uterine-sparing UF treatment and a nonsurgical UF treatment than their White counterparts; this may not be true for all women. Longer

show abstract

Surgical treatment of fibroids for subfertility

Cited by 53 publications

References 54 publications

The Effect of High-Intensity Focused Ultrasound Rays in the Treatment of Uterine Fibroids on Tissue Parameters of Endometrial Receptivity

The Effect of High-Intensity Focused Ultrasound Rays in the Treatment of Uterine Fibroids on Tissue Parameters of Endometrial Receptivity

Bedeutung der Fertilitätschirurgie bei Kinderwunsch

Black Women Are More Likely Than White Women to Schedule a Uterine-Sparing Treatment for Leiomyomas

Contact Info

Product

Resources

About