Sirkeci, F., Moss, J., Belli, A. M., McPherson, K., Daniels, J., Manyonda, I., Middleton, L., Cheed, V., Wu, O. and Lumsden, M. A. (2023) Effects on heavy menstrual bleeding and pregnancy of uterine artery embolization (UAE) or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: the FEMME randomized controlled trial. International Journal of Gynecology and Obstetrics, 160(2), pp. 492-501. (doi: 10.1002/ijgo.14626) (PMID:36511801)
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Abstract
Objective: To determine treatment options (myomectomy vs uterine artery embolization [UAE]) for women wishing to avoid hysterectomy. Methods: A multicenter randomized controlled trial was conducted on 254 women and data were collected on fibroid-specific quality of life (UFS-QOL), loss of menstrual blood, and pregnancy. Results: At 4 years, the mean difference in the UFS-QOL was 5.0 points (95% confidence interval [CI] −1.4 to 11.5; P=0.13) in favor of myomectomy. This was not statistically significant as it was at 2 years. There were no differences in bleeding scores, rates of amenorrhea, or heavy bleeding. Of those who were still menstruating, the majority reported regular or fairly regular periods: 36 of 48 (75%) in the UAE group and 30 of 39 (77%) in the myomectomy group. Twelve women after UAE and six women after myomectomy became pregnant (4 years) with seven and five live births, respectively (hazard ratio 0.48, 95% CI 0.18–1.28). There was no difference between the levels of hormones associated with the uterine reserve in each group. Conclusion: Leiomyoma are common in reproductive-aged women, causing heavy menses and subfertility. Among women with uterine fibroids, myomectomy resulted in better fibroid-related quality of life at 4 years, compared with UAE but the treatments decreased menstrual bleeding equally. There was also no significant difference in the impact of treatment on ovarian reserve.
| Item Type: | Articles |
|---|---|
| Keywords: | Uterine fibroid, myomectomy, uterine artery embolization, quality of life, United Kingdom, pregnancy rate, female, ovarian reserve. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Wu, Professor Olivia and Lumsden, Professor Mary |
| Authors: | Sirkeci, F., Moss, J., Belli, A. M., McPherson, K., Daniels, J., Manyonda, I., Middleton, L., Cheed, V., Wu, O., and Lumsden, M. A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | International Journal of Gynecology and Obstetrics |
| Publisher: | Wiley |
| ISSN: | 0020-7292 |
| ISSN (Online): | 1879-3479 |
| Published Online: | 13 December 2022 |
| Copyright Holders: | Copyright © 2022 The Authors |
| First Published: | First published in International Journal of Gynecology and Obstetrics 160(2): 492-501 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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