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infertility due to uterine fibroid

A-G Pourcelot, P Capmas, H Fernandez
Symptomatic uterine fibroids affect 25% of women of childbearing potential and are responsible for various symptoms, mainly menometrorrhagia, pelvic pain and infertility. No currently available medical treatment is able to eradicate fibroids. Two treatments are indicated preoperatively to reduce bleeding and decrease the size of fibroids: GnRH agonists and ulipristal acetate. Ulipristal acetate, a selective progesterone receptor modulator, exerts an antagonist effect on fibroid tissue, inducing apoptosis. It rapidly induces amenorrhoea (after an average of seven days of treatment) and reduces fibroid volume...
March 2017: J Gynecol Obstet Hum Reprod
Piotr Czuczwar, Anna Stępniak, Wojciech Wrona, Sławomir Woźniak, Paweł Milart, Tomasz Paszkowski
Uterine fibroids are considered to be the most frequent female benign tumours. Fibroids affect mainly women of reproductive age. The most frequently reported signs and symptoms of fibroids include disturbances of the menstrual cycle such as heavy bleeding and painful menstruation, pelvic masses associated with pelvic pain, urinary problems or constipation, as well as infertility and recurrent pregnancy loss. The mainstay of fibroid treatment is still surgery. However, many patients seek alternative treatment options for fibroids, to preserve their uterus and fertility...
December 2016: Przeglad Menopauzalny, Menopause Review
Md Soriful Islam, James H Segars, Mario Castellucci, Pasquapina Ciarmela
A growing interest has emerged on dietary phytochemicals to control diverse pathological conditions. Unfortunately, dietary phytochemical research in uterine fibroids is still under construction. Uterine fibroids/leiomyomas are benign tumors developing from the myometrium of the uterus in premenopausal women. They may occur in more than 70% of women, and approximately 25% of women show clinically significant symptoms. These include heavy and prolonged menstrual bleeding, pelvic pressure (urinary frequency, incontinence, and difficulty with urination), pelvic pain, pelvic mass, infertility, and reproductive dysfunction...
February 2017: Pharmacological Reports: PR
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Jacques Donnez, Marie-Madeleine Dolmans
Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications.Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid 'radical' surgery such as hysterectomy...
November 2016: Human Reproduction Update
Roger J Hart
Across the Western World there is an increasing trend to postpone childbearing. Consequently, the negative influence of age on oocyte quality may lead to a difficulty in conceiving for many couples. Furthermore, lifestyle factors may exacerbate a couple's difficulty in conceiving due mainly to the metabolic influence of obesity; however, the negative impacts of low peripheral body fat, excessive exercise, the increasing prevalence of sexually transmitted diseases, and smoking all have significant negative effects on fertility...
July 2016: Physiological Reviews
Péter Török, Róbert Póka
Uterine fibroid is the most common tumor in women of reproductive age. Depending on the size and location they can cause variety of symptoms. The clinical presentation may include bleeding disorders, infertility, pelvic pain and dysmenorrhea as well. Detection and precise evaluation of the number, size and location of myomas is possible due to advances in imaging and endoscopic methods. Treatment of fibroids depends on the severity and type of symptoms. There are medical, radiological and surgical options for treatment...
May 22, 2016: Orvosi Hetilap
Ayman Shehata, Naglaa Hussein, Ahmed El Halwagy, Adel El Gergawy, Mohamed Khairallah
Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma...
March 2016: Clinical and Experimental Reproductive Medicine
Joanna Kacperczyk, Paweł Bartnik, Ewa Romejko-Wolniewicz, Agnieszka Dobrowolska-Redo
Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus. Fibroids can develop anywhere within the muscular wall. Leiomyomas may be associated with infertility. Laparoscopic myomectomy is often used to remove symptomatic intramural or subserosal fibroids. Advantages of the procedure include short recovery time and minimal perioperative morbidity. At the same time, the multilayer suture technique is more complicated during laparoscopy. A rare but serious complication of laparoscopic myomectomies is uterine rupture...
March 2016: Anticancer Research
G Lo Monte, I Piva, A Graziano, B Engl, R Marci
OBJECTIVE: Uterine leiomyomatosis and especially submucosal myomas hamper the outcomes of Assisted Reproductive Techniques (ART). Even though surgical treatment eliminates gross anatomical anomalies, medical treatment should be encouraged to improve the overall structure of the uterus, thereby enabling ART. CASE PRESENTATION: We report the case of an infertile female patient suffering from symptomatic uterine fibromatosis, who received 5 mg/day ulipristal acetate (UPA), a selective progesterone receptor modulator (SPRMs), for three months before and after hysteroscopic myomectomy...
2016: European Review for Medical and Pharmacological Sciences
Leonidas I Zepiridis, Grigoris F Grimbizis, Basil C Tarlatzis
Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility...
July 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Anne Puchar, Cécile Feyeux, Dominique Luton, Martin Koskas
Fibroids, which are benign smooth-muscle tumors of clonal origin, are the most common gynecologic tumors occurring in about 20 to 25 % of women over 30 years of age. The most frequent symptoms are pelvic pain and heavy menstrual bleeding resulting in anemia. The role of fibroids in infertility remains debated but probably mostly related to submucosal location due to implantation impairment. Although most women are asymptomatic (80%), fibroids can have a considerable impact on quality of life. Considering this impact and the cost associated with their management, treatment of fibroids is a public health concern...
August 2016: Minerva Ginecologica
Aleksandra Marciniak, Jolanta Nawrocka-Rutkowska, Berenika Wiśniewska, Iwona Szydłowska, Agnieszka Brodowska, Andrzej Starczewski
Nowadays endoscopic techniques are one of the basic diagnostic and operative methods in gynecology. Laparoscopy and hysteroscopy are the most popular of them. Office hysteroscopy is a modern diagnostic and therapeutic method feasible in an outpatient room because no necessity of anesthesia. It is the first-line procedure in the infertility diagnosis and treatment of uterine pathology such as polyps, submucosal fibroids and adhesions. Limitation of this method is the cervical canal atresia. Contraindications to it are: pregnancy, uterine bleeding, active inflammation of pelvic organs, cervical cancer...
October 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Hasan Titiz
STUDY OBJECTIVE: To demonstrate safe and easy surgical steps to facilitate preconceptional laparoscopic cervical cerclage with the Titiz uterovaginal manipulator. DESIGN: Narrated step-by-step video demonstration of preconceptional laparoscopic cervical cerclage under the guidance of the Titiz uterovaginal manipulator. SETTING: Cervical incompetence or cervical insufficiency is 1 of the causes of preterm birth. Incidence is 0.1% to 1% of all pregnancies...
September 2015: Journal of Minimally Invasive Gynecology
Michal Mara, Kristyna Kubinova
Uterine artery embolization (UAE) is a minimally invasive procedure with large symptomatic potential in treatment of women with uterine leiomyomas. Due to specificities of this method and possible complications the appropriate indication is crucial. Patient' symptoms, age, plans for pregnancy, and surgical and reproductive history play a major role in decision-making regarding appropriate subjects for UAE. Close cooperation between the gynecologist and the interventional radiologist is necessary. UAE is usually offered as an alternative to surgical treatment...
2014: International Journal of Women's Health
K Kitaya, T Yasuo, Y Nakamura
The authors here report a case of an infertile woman with diffuse leiomyomatosis of the uterus, which is a rare benign pathological condition in which the myometrium is occupied by innumerable small fibroid nodules. Due to the progressive abdominal distension of the patient and the desire for pregnancy of the couple, myomectomy was performed as a primary treatment. Urgent relaparotomy was required for hematoma debridement on the following day. Despite the evidence of the follicular growth and cyclic ovarian steroid secretion, the patient had postoperative endometrial thinning that was unresponsive to hormone replacement therapy...
2014: Clinical and Experimental Obstetrics & Gynecology
L K Hawkins, K F Correia, S S Srouji, M D Hornstein, S A Missmer
STUDY QUESTION: What is the relationship between pre-cycle uterine length and IVF outcome (chemical pregnancy, clinical pregnancy, spontaneous abortion and live birth)? SUMMARY ANSWER: Women at extremes of uterine length (<7.0 or >9.0 cm) were less likely to achieve live birth and women with uterine lengths <6.0 cm were also more likely to experience spontaneous abortion. WHAT IS KNOWN ALREADY: A prospective study of 807 women published in 2000 found that implantation and clinical pregnancy rates were highest in women with uterine lengths between 7...
November 2013: Human Reproduction
Pietro Santulli, Marc Even, Sandrine Chouzenoux, Anne-Elodie Millischer, Bruno Borghese, Dominique de Ziegler, Frédéric Batteux, Charles Chapron
STUDY QUESTION: Are interleukin-33 (IL-33) serum levels higher in women with uterine leiomyoma compared with controls without leiomyoma? SUMMARY ANSWER: Serum IL-33 is elevated in women with uterine leiomyoma and correlated with features of uterine leiomyoma tumour burden, namely fibroid number, size and weight. WHAT IS KNOWN ALREADY: Uterine leiomyomas are the most common benign tumours in premenopausal women associated with major tissue fibrosis...
August 2013: Human Reproduction
Mostafa Metwally, Ying C Cheong, Andrew W Horne
BACKGROUND: Fibroids are the most common benign tumours of the female genital tract and are associated with numerous clinical problems including a possible negative impact on fertility. In women requesting preservation of fertility, fibroids can be surgically removed (myomectomy) by laparotomy, laparoscopically or hysteroscopically depending on the size, site and type of fibroid. Myomectomy is however a procedure that is not without risk and can result in serious complications. It is therefore essential to determine whether such a procedure can result in an improvement in fertility and, if so, to then determine the ideal surgical approach...
November 14, 2012: Cochrane Database of Systematic Reviews
S A Anwary, M Alfazzaman, Z A Nasreen
Sub-fertility affects approximately 15% of couples. Approximately 40% of cases involve a male factor, 40% involve a female factor and the remainder involves both sexes. The polycystic ovary syndrome (PCOS) is one of the most common causes of sub-fertility due to anovulation in women. Treatment of sub-fertility in female partners mainly depends on the laparoscopic findings of patients with PCOS, pelvic inflammatory disease (PID), endometriosis and fibroid uterus. Between February 2007 and April 2009, 73 subfertile women with PCOS were evaluated on their laparoscopic findings in a tertiary hospital in Dhaka city...
July 2011: Mymensingh Medical Journal: MMJ
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