title: Effects of utero-ovarian anastomoses on basal follicle-stimulating hormone level change after uterine artery embolization with tris-acryl gelatin microspheres.
abstract: OBJECTIVE
  To assess the prevalence of anastomoses between uterine and ovarian arteries on angiography and their impact on changes in basal follicle-stimulating hormone (FSH) level after uterine artery embolization (UAE).
  
  
  METHODS
  Consecutive premenopausal women who underwent UAE for symptomatic uterine leiomyomata according to a uniform embolization technique with tris-acryl gelatin microspheres at a single institution were included in the study. Basal FSH levels before UAE and 6 months after UAE were compared for patients with and without anastomoses between uterine and ovarian arteries on angiography.
  
  
  RESULTS
  Among 124 patients included in the study (mean age, 43.1+/-5.7 years), patent anastomoses between the uterine and ovarian arteries were detected by angiography in 55 patients (44.4%). Overall, 11.3% of 124 patients showed an increase in basal serum FSH level of greater than 20 mIU/mL after UAE. In patients with utero-ovarian anastomoses, 18.2% showed an increase of greater than 20 mIU/mL after UAE, compared with 5.8% of patients without such anastomoses (P=.03). Mean basal FSH increase after UAE in patients with anastomoses was 8.4+/-20.2 mIU/mL, compared with 2.7+/-10.6 mIU/mL in patients without anastomoses (P=.047). Among patients with anastomoses, the 50- to 54-year age group had the highest percentage of patients with an FSH increase greater than 20 mIU/mL (50.0%) after UAE, followed by patients in the 45- to 49-year age group (15.4%).
  
  
  CONCLUSIONS
  Angiographically detected anastomoses between the uterine artery and the ovarian artery are not uncommon. UAE in patients with anastomoses is associated with a greater risk of significant increase of basal FSH level than in UAE in patients without anastomoses. The pathophysiologic processes resulting in change of FSH level may be a reflection of diminished ovarian function, but further study is warranted to delineate the precise mechanism.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Blalock 545, Baltimore, Maryland 21205-4010, USA. sikhkim@jhmi.edu
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
authors.forename: Jason
authors.initials: J
authors.lastname: Tsai
authors.forename: Judy M
authors.initials: JM
authors.lastname: Lee
authors.forename: Russell
authors.initials: R
authors.lastname: Vang
authors.forename: John G
authors.initials: JG
authors.lastname: Griffith
authors.forename: Edward E
authors.initials: EE
authors.lastname: Wallach
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use; D015901:Angiography, Digital Subtraction; D001163:Arteriovenous Anastomosis / Q000000981:diagnostic imaging*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005780:Gelatin / Q000627:therapeutic use; D006801:Humans; D007889:Leiomyoma / Q000097:blood / Q000628:therapy*; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply* / Q000378:metabolism; D017697:Premenopause; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000097:blood / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000378:metabolism
chemical_list: D000180:Acrylic Resins; C496735:trisacryl gelatin microspheres; D005780:Gelatin; D005640:Follicle Stimulating Hormone