Excerpts From the World Medical Literature.

Abstract

Summary: This meta-analysis reviewed three cohort and three case-control studies that included a total of 353 women who underwent uterine artery embolization (UAE) where measurement of antimüllerian hormone (AMH) was used as the end point to determine impact on ovarian reserve. The primary outcome was change in AMH level after UAE; secondary outcomes were changes in follicle stimulating hormone (FSH) and antral follicle count (AFC). The studies included in this meta-analysis were evaluated for quality, risk of bias, and heterogeneity. Length of follow-up was between 3 and 6 months. Various embolization agents were used, but the UAE technique was quite consistent. Women over age 40 were included in several of these studies. Pooled analysis of all six studies showed no significant change in post-embolization AMH concentration (weighted mean difference [WMD] −0.60 ng/mL; 95% confidence interval [CI] −1.51 to 0.31). The results were the same for women aged <40 years. There was no statistically significant change in AMH concentration at 1 year of follow-up (WMD −0.09; 95% CI −0.32 to 0.14). In terms of secondary outcomes, there was no significant difference in FSH level post-UAE (WMD 4.32; 95% CI −0.53 to 9.17); two studies that included a total of 62 women and evaluated AFC at 3 months as an outcome measure showed a significant decline in AFC 3 months post-UAE (WMD −3.28; 95% CI −5.62 to −0.93).