Ovarian Function after Uterine Artery Embolization and Hysterectomy

Abstract

Study Objective To evaluate the effect of uterine artery embolization (UAE) and hysterectomy on ovarian function. Design Prospective case control study (Canadian Task Force classification II-2). Setting University teaching hospital. Patients Eighty-four healthy premenopausal women with symptomatic uterine myoma(s) undergoing UAE or hysterectomy. Intervention Patients had blood drawn to measure follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and underwent transvaginal ultrasound to measure volume of the myoma(s) and uterus on cycle day 3 before the procedures. These measurements were repeated 3 and 6 months after treatment. Measurements and Main Results The main outcome was the differences in serum FSH, LH, E2, and ultrasound findings before and after UAE or hysterectomy. Of the 68 patients who underwent UAE and 16 who underwent hysterectomy, 48 and 13 respectively, completed 6-month follow-up. The mean age of the patients in the UAE group was 44.9 ± 3.8 years and 43.7 ± 5.6 years in the hysterectomy group. There was no significant difference in serum FSH before (8.9 ± 0.7 IU/L) and 6 months after UAE (9.9 ± 1.0 IU/L), and between the baseline (10.4 ± 1.8 IU/L) and 6 months posthysterectomy (7.8 ± 1.8 IU/L). The uterine volume 6 months after UAE (361 ± 50 mL) was significantly smaller than before UAE (538 ± 38mL; p = .005, 95% CI 44–241). Compared with baseline (154 ± 20 mL), the dominant myoma volume was smaller at 6 months after UAE (97 ± 16 mL; p <.05, 95% CI 1.57–62). Conclusion Uterine artery embolization is associated with a significant reduction in myoma and uterine volume. Ovarian function at 6 months, as indicated by day 3 FSH levels, is not affected by UAE or hysterectomy.