Spontaneous Pregnancy Following Ulipristal Acetate Treatment in a Woman with a Symptomatic Uterine Fibroid.

BACKGROUND: Uterine fibroids (UFs) may impair fertility and promote miscarriage. The optimal treatment for women with UFs who wish to conceive is uncertain.

CASE: A 35-year-old woman of African ancestry with a history of recurrent miscarriage (gravida 5, para 0) had a solitary submucosal UF (volume: 102.4 cm(3)) extending into the uterine cavity. Following a three-month course of ulipristal acetate (UPA) 5 mg daily, UF volume decreased to 72.1 cm(3). The patient conceived approximately two months after discontinuing UPA. She had an uncomplicated pregnancy and underwent a planned induction of labour at 38 weeks' gestation. The patient had a normal vaginal delivery of a healthy male infant weighing 3130 g. An ultrasound performed three months post-delivery revealed further reduction in UF volume to 14.5 cm(3).

CONCLUSION: This report demonstrates the utility of UPA in the management of women with UFs who desire pregnancy but who opt for non-surgical management.