Ovarian function after uterine artery embolization and hysterectomy.
OBJECTIVE
To evaluate the effect of uterine artery embolization (UAE) and hysterectomy on ovarian function.


METHODS
Prospective case control study (Canadian Task Force classification II-2).


METHODS
University teaching hospital.


METHODS
Eighty-four healthy premenopausal women with symptomatic uterine myoma(s) undergoing UAE or hysterectomy.


METHODS
Patients had blood drawn to measure follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and underwent transvaginal ultrasound to measure volume of the myoma(s) and uterus on cycle day 3 before the procedures. These measurements were repeated 3 and 6 months after treatment.


RESULTS
The main outcome was the differences in serum FSH, LH, E2, and ultrasound findings before and after UAE or hysterectomy. Of the 68 patients who underwent UAE and 16 who underwent hysterectomy, 48 and 13 respectively, completed 6-month follow-up. The mean age of the patients in the UAE group was 44.9 +/- 3.8 years and 43.7 +/- 5.6 years in the hysterectomy group. There was no significant difference in serum FSH before (8.9 +/- 0.7 IU/L) and 6 months after UAE (9.9 +/- 1.0 lU/L), and between the baseline (10.4 +/- 1.8 lU/L) and 6 months posthysterectomy (7.8 +/- 1.8 lU/L). The uterine volume 6 months after UAE (361 +/- 50 mL) was significantly smaller than before UAE(538 +/- 38mL; p =.005, 95% CI 44-241). Compared with baseline (154 +/- 20 mL), the dominant myoma volume was smaller at 6 months after UAE (97 +/- 16 mL; p <.05, 95% CI 1.57-62).


CONCLUSIONS
Uterine artery embolization is associated with a significant reduction in myoma and uterine volume. Ovarian function at 6 months, as indicated by day 3 FSH levels, is not affected by UAE or hysterectomy.
Healey
Sarah
S
Department of Obstetrics and Gynecology, McGill University, Montreal, Canada.
Buzaglo
Karen
K
Seti
Laurent
L
Valenti
David
D
Tulandi
Togas
T
D000328:Adult; D016022:Case-Control Studies; D004621:Embolization, Therapeutic; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000601:surgery*; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000098:blood supply*
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone