Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids

BACKGROUND Currently,the use of dienogest in clinical practice has increased significantly,and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis;however,the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.AIM To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.METHODS The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.RESULTS The maximum uterine fibroid diameter and volume increased after 3 months,6 months and 1 year of dienogest treatment compared with those before treatment(P<0.01).The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment,but the difference was not significant(P>0.05).Endometrial thickness and antigen 125 levels were significantly thinner and decreased,respectively,after dienogest treatment(P<0.01).Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume(r=0.792,P<0.01).Among 64 patients with dysmenorrhea,63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest,and all patients experienced significant relief of dysmenorrhea after 12 months.Patients were able to tolerate the drugs,with an average drug tolerance score of 8.73.CONCLUSION The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts,but it cannot inhibit uterine fibroid growth.

Molecular Docking Studies of Botanical Beverage Mix Berries (LIFEGREENTM) against Breast Cancer Cells from Targeted Protein 1QQG, 7B5Q & 7B5O & Uterine Fibroid from Targeted Protein 2AYR, 6T41 & 3GRF

Fibroids, also called leiomyomas or myomas, are communal tumors of the muscle or uterine wall that affect about 20% of females who are of reproductive age. They can look as if singly or in clusters, and they often cease to grow after menopause. Fibroids can be classified as intramural, sub serosal, pedunculated, or submucosal based on where they are positioned in the uterus. Although fibroids are benign, they can grow quickly and cause a range of symptoms, such as pelvic pressure, heavy menstrual flow, and infertility. As a result, fibroids are a main reason behind hysterectomy surgeries. The majority of cases of breast cancer are ductal and lobular cancers, making it the second utmost common cancer in women international. Gene mutations like those in BRCA1 or BRCA2 knowingly raise the risk of breast and other cancers, typically with an earlier cancer onset. Cancer risk is influenced by a complex interplay of genetic abnormalities, environmental factors, and lifestyle selections. Further research into these relations is domineering. Although they are common in uterine leiomyomas, especially multiple leiomyomas, MED12 mutations do not significantly correlate with tumor size. These mutations have also been noticed in smooth muscle tumors and leiomyosarcomas, two other types of uterine cancer. The identification of MED12 mutations as the sole genetic abnormality originates in leiomyomas raises the opportunity of a role in the genesis of cancer. 10% - 15% of women who are of reproductive age have endometriosis, which grants serious difficulties because of its chronic nature and range of clinical symptoms. Even after effective surgeries, issues reoccur often, adding to the enormous financial burden. The effects of MED12 mutations have been experiential in recent studies examining the molecular causes of endometriosis-associated infertility, which have shown anomalies in cellular connections and signaling cascades. Computational techniques were used in this study to investigate LifeGreenTM’s potential to prevent uterine fibroids and breast cancer. The efficacy of LifeGreenTM as a preventive measure or a treatment for common gynecological matters was examined and modeled. We investigated the mechanisms underlying LifeGreenTM’s benefits in the treatment of uterine fibroids and breast cancer using computational techniques. Our research contributes to our understanding of its potential therapeutic benefits for women’s health.

Clinical and Demographic Profile of Women with Uterine Fibroids Living in Puerto Rico

Introduction: Uterine leiomyomas, or fibroids, are prevalent benign tumors affecting up to 70% of reproductive-age women in the United States, significantly impacting productivity and quality of life. Despite their commonality, the epidemiology and clinical patterns of leiomyomas in Puerto Rico remain inadequately researched. Methods: This study conducted a secondary data analysis using clinical, menstrual cycle characteristics, and demographic data from self-administered questionnaires of women undergoing diagnostic laparoscopy for endometriosis in Puerto Rico. Chi-square tests and t-tests analyzed categorical and continuous variables, respectively (p Results: Among 1,610 endometriosis cases, 312 included uterine fibroids. Prevalence estimates were 10.3% (40 years). Primiparous women averaged 22.14 years, with 40.71% having 2 - 3 pregnancies and 26.28% experiencing miscarriages. Symptoms included infertility (29.5%), dyspareunia (40.7%), severe pain (50%), and dysmenorrhea (75.6%). Comorbidities included ovarian cysts (52.2%) and abnormal uterine bleeding (37.8%). Conclusions: Advanced age, parity, and comorbidities like diabetes and hypertension were prevalent in our cohort. Understanding the epidemiological profile of women living in Puerto Rico with uterine fibroids is crucial for improving diagnostic awareness and enhancing patient care.

Associated Factors and Consequences of Uterine Fibroids in Hospitals in the Borgou Department of Benin in 2022

Introduction: Uterine fibroids are the most common gynecological tumors in women of childbearing age and have multiple clinical manifestations. Objective: To determine factors associated with uterine fibroids in the Borgou department of Benin in 2022. Method: Descriptive, analytical cross-sectional study from August 22 to September 22, 2022. The sample consisted of women consulting for gynecological problems in 6 hospitals in the Borgou department in the North of Benin. Results: Of the 744 women surveyed, 10.1% were diagnosed with uterine fibroids. Women with uterine fibroids were often married, paucigesture, and nulliparous. Their main reasons for consultation were the desire for motherhood (50.7%), pelvic pain (46.7%), and genital hemorrhage (14.7%). Age, history of miscarriage, high blood pressure, and diabetes were significantly associated with the presence of uterine fibroids (Conclusion: Uterine fibroids are common in hospitals in northern Benin. There were factors associated with them that should be taken into account in management strategies.

Evaluation of the Efficacy and Effectiveness of Hysteroscopic Electroresection in the Treatment of Submucosal Uterine Fibroids

Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.

Discussion on the Application of Operating Room Nursing in Patients with Uterine Fibroids and Diabetes

Objective: To analyze the application value of surgical nursing in patients with uterine fibroids and diabetes. Method: Sixty diabetic patients who agreed to undergo surgery for uterine fibroids at the Sun Yat-sen University Cancer Center from January 2021 to May 2022 were randomly selected as the study subjects. According to criteria such as number of patients, age, nursing methods, and treatment methods, the patients were evenly divided into an observation group and a control group. The control group received routine nursing measures, while the observation group received focused surgical nursing measures based on the routine ones. The blood glucose and blood lipid metabolism status, the incidence of adverse reactions, and nursing satisfaction were compared between the two groups. Results: The blood glucose and blood lipid metabolism status of the observation group were safer than those of the control group (P < 0.05). The observation group had advantages in terms of the incidence of adverse reactions and nursing satisfaction compared to the control group (P Conclusion: Systematic surgical nursing for patients with uterine fibroids and diabetes during surgery can help patients control their blood glucose and blood lipid metabolism status, reduce the incidence of adverse reactions, and improve the patient’s experience during the treatment stage.

Surgical Management of Uterine Fibroids: About 175 Cases

Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management of patients with uterine fibroids. Patients and Method: We carried out a retrospective and descriptive study carried out over a period of 30 months, from August 1, 2017 to January 31, 2020, concerning all patients who underwent surgery for the treatment of uterine myomatosis in the department of Gynecology Obstetrics of the Hospital Principal of Dakar. The data was collected from the patients’ medical records and analyzed using Excel version 2016 and R version 4 software. Results: We collected 175 surgical interventions for uterine fibroids, representing 44.7% of gynecological interventions. Most of the patients were between 30 and 39 years old, with an average age of 39 years. The nulliparous were the majority with 64.6%. The clinical symptomatology was represented by genital bleeding (32.6%), pelvic pain (18.85%) and infertility (12.6%). The diagnosis was confirmed by pelvic ultrasound in all patients with variable myoma topography. A myomectomy was performed in 82.3% of cases and a total hysterectomy in 17.7%. The postoperative course was simple in 94.2% of cases, and the results of treatment revealed a disappearance of symptoms in 94.3% of cases. Conclusion: Surgery occupies a prominent place in the management of uterine fibroids.

The clinical study of ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute combined with HIFU in the treatment of uterine fibroids

Objective The aim of this study was to investigate the energy deposition in the target area of high intensity focused ultrasound （HIFU） with ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute Methods Eighty patients with hysteromyomas were randomly divided into two groups： group HIFU （group H） and group HIFU combined with ullrasound-guided inlra-hysteromyoma injectionn of ethyl alcohol absolute （group E ＋ H）. Patients in group E ＋ H received an ullrasound-guided injection of absolute ethyl alcohol 1 h before HIFU treatment. The irradiation time, irradiation dose, energy efficiency factor （radiation energy required for ablation of a myoma per unit of volume）, grey variation, pain score, and adverse reactions were compared between the two groups. An independent sample t-test was used with a two- tailed P-value of 〈 0.05. Results The irradiation time, irradiation dose, and energy efficiency factor were significantly lower in group E ＋ H than those in group H （P 〈 0.05）. The hysteromyomas of patients in group E＋H appeared as dominantly hyperechoic masses, and those of patients in group H appeared as hyperechoic tissue （non- mass）. The incidence of adverse reactions and pain score were higher in group H than those in group E ＋ H （P 〈 0.05）. Conclusion Ultrasound-guided inlra-hysteromyoma injection of ethyl alcohol absolute can enhance the energy deposition of HIFU in the uterine fibroids, improve the treatment efficiency, shorten the treatment time, reduce the treatment dose, and reduce the pain and complications for the patients.

Ventral hernia after high-intensity focused ultrasound ablation for uterine fibroids treatment:A case report

BACKGROUND High-intensity focused ultrasound(HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids.Although this procedure is safe and effective,adverse outcomes are becoming a major problem.CASE SUMMARY We present a case of ventral hernia that occurred as a rare and delayed complication of HIFU ablation for uterine fibroids treatment.The patient came to the hospital with abdominal bloating that occurred 6 mo after ultrasound-guided HIFU ablation for managing uterine fibroids.The ventral hernia,which occurred due to atrophied muscle layers following the procedure,was confirmed by imaging studies and intraoperative findings.She required a hernia repair with mesh and hysterectomy for definitive treatment of uterine fibroid.CONCLUSION High-intensity ultrasound ablation should be performed only on appropriate candidates.Patients should be educated about potential complications of the procedure and the possibility of subsequent treatment.Post-procedural long-term follow-up for detecting delayed adverse effects is important.

Effect of selective uterine artery embolization on symptomatic uterine fibroids

Objective： To evaluate the outcomes of selective uterine artery embolization （SUAE） in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography （CDUS）. Methods： As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results： SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [（322± 12） cm^3] and uterine fibroids [（125±46） cm^3], their volumes in post-SUAE were （144±72） cm^3 and （51 a：l 1） cm^3 （P〈0.01）, and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE （P〉0.05）. After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved （P〈0.01）. 90.8% （59/65） women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% （34/40） complications were minor, requiring no therapy. 9.2% （6/65） had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion： SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women＇s health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.

Laparoscopic myomectomy versus open myomectomy in uterine fibroid treatment: A meta-analysis

Objective:Uterine fibroids are the most commonly occurring benign solid tumors in women,and laparoscopic or open myomectomy constitutes the primary option for treatment.However,both methods are under debate currently in terms of efficacy and safety.In this meta-analysis we assessed the efficacy and safety of the two procedures.Methods:We conducted a comprehensive literature search of PubMed,ScienceDirect,and the Cochrane Library in December 2020.The search terms included“open myomectomy”,“myomectomies”,“laparoscopic”,and“uterine fibroids”.We then selected the randomized control trials published from 1996 to 2019 and compared laparoscopic and open myomectomies.Results:We included 10 studies of 449 patients who underwent laparoscopic myomectomy and 449 patients who underwent open myomectomy.The data revealed that laparoscopic myomectomy was associated with reduced blood loss(MD=-34.43;95%CI,-34.92 to-33.94;p<0.001),an attenuated decline in hemoglobin(MD=-1.04;95%CI,-1.14 to -0.93;p<0.001),less post-operative pain at 24 h(MD=-0.51;95%CI,-0.83 to -0.19;p=0.002),and fewer overall complications(OR=0.42;95%CI,0.24 to 0.71;p=0.001)relative to open myomectomy;but the former possessed a longer operative time(MD=12.96;95%CI,9.94 to 15.97;p<0.001).There were no significant differences in pregnancy rate(OR=1.39;95%CI,0.72 to 2.68;p=0.33)or recurrence rate of postoperative uterine fibroids(OR=1.15;95%CI,0.60 to 2.18;p=0.67)between the two groups.Conclusion:Laparoscopic myomectomy displayed superior results compared to open myomectomy,although the former involved a longer operating time.

CT-Monitored Percutaneous Cryoablation of Uterine Fibroids after Uterine Artery Embolization

OBJECTIVE To investigate the effects of percutaneous cryoablation on uterine fibroids using computed tomographic （CT） guidance after uterine artery embolization.METHODS Twelve patients who failed to respond to uterine artery em- bolization were treated using percutaneous cryoablation. All patients had undergone previous uterine artery embolization an average of 1.2 years （0.7-1.6 years） ago. Two cases had abnormal bleeding, and the other 10 suffered from pressure and/or pelvic pain. Myoma diameters were 4 cm to 16.5 cm. By using CT guidance, 2.0, 2.4, 3.0 or 3.8 mm cryoprobes were placed into the fibroid, and two 15-20 rain freezing processes were performed. Hemostasis was achieved only by pressing the incisions for several minutes. MR-imaging was performed before the procedure to measure the size and number of fibroid tumors, and follow- up MR-imaging determined the reduction of the lesions.RESULTS All patients were discharged within 48 h of treatment. Almost no hemorrhage was found in all of the cases. No bladder or bowel injury or significant postsurgery pain was reported. Ice spheres were readily visualized at CT. Beam-hardening artifact from the metal probes was present, but did not interfere with the procedure. Myomas regressed up to 76.3% after 12 months of treatment, and the primary symptoms improved in all treated women.CONCLUSION CT-monitored percutaneous cryoablation is an effective and minimally invasive therapy for symptom relief and fibroid shrinkage after the failure of uterine artery embolization.

Research Progress of TCM Treatment of Uterine Fibroids

Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.

The Comparison Between Two Kinds of Integrative Medicine Therapy with the Single Mifepristone in the Treatment of Uterine Fibroids

Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.

Ulipristal Acetate (UPA): An Alternative Option to Surgery for Uterine Fibroids in Reproductive Age: A Review

Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.

A study on the frequency of thyroid nodules and uterine fibroids in Chinese breast cancer patients

Background:Single or multiple thyroid nodules and uterine fibroids are the most common benign gynecologic disease.An increasing number of breast cancer are accompanied with thyroid nodules or uterine fibroids or both of them.However,the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer is unclear.Objective:To study the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer.Methods:A retrospective cohort study conducted in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(China)that included 1,322 female cancer survivors who went to our hospital from January 2014 to November 2019.In this study,we evaluated the frequency of thyroid nodules and uterine fibroids in breast cancer survivors in comparison with other cancer survivors.Besides,we compare the frequency of thyroid nodules and uterine fibroids among different luminal breast cancer.Results:In this study,there were 245 breast cancer survivors,including 58 cases with thyroid nodule,52 cases with uterine fibroids,17 cases with both,152 cases with none.And 1,077 other cancer survivors were collected,including 142 cases with thyroid nodule,172 cases with uterine fibroids,25 cases with both,788 cases with none.According to statistical analysis,the incidence of thyroid nodule and uterine fibroids in breast cancer patients is significantly higher than that in non-breast cancer patients(P<0.01 and P<0.05).Between the molecular classification of breast cancer,among 245 BC patients,58 were combined with thyroid nodule,including 57 cases of luminal-A type BC and 22 cases of combined thyroid nodule;101 cases of luminal-B type BC and 20 cases of combined thyroid nodule;50 cases of HER2-positive over expression type BC and 13 cases of combined thyroid nodule;37 cases of TNBC and 3 cases of combined thyroid nodule,Patients with luminal-A BC have a higher incidence of thyroid nodules compared to other types of BC.Among 245 BC patients,there were 52 cases with uterine fibroids,including 57 cases of luminal-A type BC,5 cases with uterine fibroids;101 cases of luminal-B type BC,32 cases with uterine fibroids;50 cases of HER2-positive over expression type BC,11 cases with uterine fibroids;37 cases of TNBC,4 cases with uterine fibroids.Luminal-B breast cancer is more likely to suffer from uterine fibroids than other types of breast cancer.In addition,breast cancer patients with both thyroid nodules and uterine fibroids had significantly higher luminal-B than other subtypes.Conclusions:This study demonstrates that breast cancer women have a significantly greater incidence rate of thyroid nodules and uterine fibroids,and is higher at Luminal A or Luminal B.We consider these findings may contribute to the identification of liver channel of foot jueyin following underlying this disease association.

A Case Report on Pulmonary Benign Metastasizing Leiomyoma with Recurrent Uterine Fibroids

Pulmonary benign metastasizing leiomyoma(PBML)is a type of benign metastasizing leiomyoma(BML),which metastasizes to lungs.In view of the rarity and nonspecific imaging characteristics of PBML,this condition is easily misdiagnosed as malignant lung cancer.This is a case report of a 39-year-old lady in whom multiple bilateral lung nodules were found during a health checkup and was diagnosed with PBML.The patient had recurrent uterine fibroids and underwent myomectomy twice,7 years and 3 years ago,respectively,before the diagnosis of PBML was made.This patient was asymptomatic,and regular examinations were normal.Her laboratory investigations were all within normal range.Computed tomography(CT)showed multiple nodules in bilateral lungs.In order to confirm the disease,thoracoscopic nodule resection and tissue biopsy were performed.Hematoxylin eosin(HE)staining showed spindle-shaped cells,while immunohistochemical staining revealed positive for desmin,smooth muscle actin(SMA),estrogen receptor(ER),and progesterone receptor(PR),which are all PBML markers.The patient was followed-up without any further treatment.After 8 months of follow-up,CT scan revealed an increased number of nodules.This is unique case because of the recurrence of uterine fibroids,which means that the patient is susceptible to it.Our report may give a new insight to the relationship between the susceptibility of uterine fibroids and the onset and progression of PBML.

Research Progress of TCM Treatment of Uterine Fibroids

Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.

Impact of uterine artery embolization on ovarian function and pregnancy outcome after uterine-fibroids treatment:A prospective study

Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus.It is the most common gynecological disorder,affecting up to 80%of women of reproductive age.Uterine fibroids can cause various symptoms such as abnormal uterine bleeding,pelvic pain,infertility,and pregnancy complications.The treatment options for uterine fibroids include medical therapy,surgical intervention,and minimally invasive techniques.AIM To compare ovarian function of women with uterine fibroids who did or did not undergo uterine artery embolization(UAE).METHODS This prospective cohort study enrolled 87 women with symptomatic uterine fibroids who underwent UAE,and 87 women with the same symptoms who did not undergo UAE but received conservative management or other treatments.The two groups were matched for age,body mass index,parity,and baseline characteristics of uterine fibroids.The primary outcome was ovarian function that was evaluated by serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH),as well as ovarian reserve tests,such as antral follicle count(AFC)and ovarian volume(OV).The secondary outcome was fertility that was evaluated based on the menstrual cycle,ovulation,conception,pregnancy,and delivery.The participants were followed-up for 36 months and assessed at 1,3,6,12,24,and 36 months after treatment.RESULTS The study found that the most common minor complication of UAE was postembolization syndrome in 73.6% of women,resolving within a week.No significant differences were observed between the UAE group and the control group in serum levels of reproductive hormones(FSH,LH,E2,AMH)and ovarian reserve indicators(AFC,OV)at any point up to 36 months post-treatment.Additionally,there were no significant differences in conception,pregnancy,or delivery rates,with the average time to conception and gestational age at delivery being similar between the two groups.Birth weights were also comparable.Finally,there was no significant correlation between ovarian function,fertility indicators,and the type or amount of embolic agent used or the change in fibroids posttreatment.CONCLUSION UAE resulted in significantly positive pregnancy outcomes,no adverse events post-treatment,and is a safe and effective treatment for uterine fibroids that preserves ovarian function and fertility.

Effect of Down-regulation of MMP-2 by Quercetin on the Migration and Invasion of Uterine Fibroids Cells through the cAMP Signaling Pathway

Objective:To investigate the effect of down-regulation of matrix metalloproteinase-2(MMP-2)by down-regulating the cyclic adenosine monophosphate(cAMP)signaling pathway on the migration and invasion of uterine fibroids cells.Methods:A total of 65 female SD rats were randomly divided into five groups after being adaptively fed for 7 d.Except for the blank group,the remaining four groups of rats were injected with 0.05 mg/(100 g·d)estradiol benzoate and 0.5 mg/(100g·d)progesterone into the muscle to establish a uterine fibroids rat model.After successful modeling,the blank group and model group were given 200 mg/(kg·d)physiological saline by gavage,the low-dose group was given 100 mg/(kg·d)mifepristone by gavage,the medium-dose group was given 200 mg/(kg·d)mifepristone by gavage,and the high-dose group was given 300 mg/(kg·d)mifepristone by gavage.After continuous gavage treatment for 21 d,serum and uterine tissues were collected from rats to observe and compare the expression levels of MMP-2 mRNA,TIMP-2 mRNA,estradiol(E2),cAMP signaling pathway related proteins,and the migration and invasive ability of uterine fibroids cells in the five groups of rats.Results:The expression levels of MMP-2 mRNA and E2in the high-dose group were lower than those in the low-dose group and the medium-dose group,and the expression level of TIMP-2 mRNA was higher than that in the low-dose group and the medium-dose group(P<0.05).The number of cell migration in a single visual field of rats in the high-dose group was lower than that in the low-dose group and the medium-dose group(P<0.05).The number of cell invasion in a single visual field of rats in the high-dose group was lower than that in the low-dose group and the medium-dose group(P<0.05).The mRNA expression levels of cAMP,PDE and PK in the high-dose group were higher than those in the low-dose group,and the mRNA expression levels of AC in the high-dose group were lower than those in the low-dose group(P<0.05).The mRNA expression levels of cAMP and PDE in the high-dose group were higher than those in the mediumdose group(P<0.05).Conclusion:Letrozole may down-regulate the expression level of MMP-2 through the cAMP signaling pathway to inhibit the migration and invasion of uterine fibroids cells.With increasing doses of letrozole,its inhibitory effect on the migration and invasion of uterine fibroids cells will be enhanced.However,the optimal dosage of letrozole for inhibiting the migration and invasion of uterine fibroids cells is yet to be determined.