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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

Title: 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
Authors: Sirkeci, Fusun; Moss, John; Belli, Anna M.; McPherson, Klim; Daniels, Jane; Manyonda, Isaac; Middleton, Lee; Cheed, Versha; Wu, Olivia; Lumsden, Mary A.
Publisher Information: Wiley
Publication Year: 2023
Collection: University of Glasgow: Enlighten - Publications
Description: 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.
Document Type: article in journal/newspaper
File Description: text
Language: English
Relation: https://eprints.gla.ac.uk/288548/1/288548.pdf; Sirkeci, Fusun, Moss, John, Belli, Anna M., McPherson, Klim, Daniels, Jane, Manyonda, Isaac, Middleton, Lee, Cheed, Versha, Wu, Olivia ORCID logoorcid:0000-0002-0570-6016 and Lumsden, Mary A. ORCID logoorcid:0000-0003-2998-9185 (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)
DOI: 10.1002/ijgo.14626
Availability: https://eprints.gla.ac.uk/288548/; https://eprints.gla.ac.uk/288548/1/288548.pdf; https://doi.org/10.1002/ijgo.14626
Rights: cc_by_4
Accession Number: edsbas.1B4CD622
Database: BASE