Long-term effects of uterine fibroid embolization on ovarian reserve: a prospective cohort study.
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.
Tropeano
Giovanna
G
Department of Obstetrics and Gynecology, Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy. giovanna.tropeano@rm.unicatt.it
Di Stasi
Carmine
C
Amoroso
Sonia
S
Gualano
Maria Rosaria
MR
Bonomo
Lorenzo
L
Scambia
Giovanni
G
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*