title: Long-term effects of uterine fibroid embolization on ovarian reserve: a prospective cohort study.
abstract: OBJECTIVE
  To determine whether uterine fibroid embolization may advance ovarian follicular depletion in reproductive-aged women with apparently normal baseline ovarian function.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University tertiary care center.
  
  
  METHODS
  Thirty-six patients aged 26 to 39 years with fibroids, regular menstrual cycles, and day 3 serum FSH levels<10 mIU/mL and 36 matched control women.
  
  
  METHODS
  Day 3 serum FSH and E2 levels and ultrasound-based antral follicle count and ovarian volume were determined before (baseline) and at 12, 24, 36, 48, and 60 months after embolization and compared with those of the control group. Menstrual status was determined annually on the basis of prospectively recorded menstrual calendars.
  
  
  METHODS
  Longitudinal changes in hormone levels, ultrasound measures, and bleeding patterns.
  
  
  RESULTS
  Although the FSH and E2 levels increased significantly and the antral follicle count and ovarian volume values declined significantly over time within the groups, no significant differences were found between the groups. The cycle remained regular in all but two women (one in the embolization group and one in the control group), who started having cycle irregularity after 24 months and 36 months follow-up, respectively.
  
  
  CONCLUSIONS
  This long-term follow-up study suggests that fibroid embolization does not lead to an accelerated decline in ovarian reserve in younger patients.
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy. giovanna.tropeano@rm.unicatt.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tropeano
authors.forename: Carmine
authors.initials: C
authors.lastname: Di Stasi
authors.forename: Sonia
authors.initials: S
authors.lastname: Amoroso
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Gualano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D002452:Cell Count; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000534:rehabilitation; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*