Long-term effects of uterine fibroid embolization on ovarian reserve: a prospective cohort study.

摘要

OBJECTIVE: To determine whether uterine fibroid embolization may advance ovarian follicular depletion in reproductive-aged women with apparently normal baseline ovarian function. DESIGN: Prospective cohort study. SETTING: University tertiary care center. PARTICIPANT(S): 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. INTERVENTION(S): 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. MAIN OUTCOME MEASURE(S): Longitudinal changes in hormone levels, ultrasound measures, and bleeding patterns. RESULT(S): 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. CONCLUSION(S): This long-term follow-up study suggests that fibroid embolization does not lead to an accelerated decline in ovarian reserve in younger patients.