The Comparison of Ovarian Reserve After Uterine Artery Embolization and Hysterectomy for Uterine Fibroma

Abstract

Background: The purpose of this study was to compare the ovarian reserve before and after uterine artery embolization and hysterectomy for uterine fibroma treatment. Methods: After obtaining the approval of the Ethics Committee of Kermanshah Medical University, this study was carried out in Imam Reza Hospital. Between March 2011 and May 2013, 66 women who suffered from symptomatic fibroma were studied. Hysterectomy with retained ovaries was done on 33 patients and uterine artery embolization (UAE) was done on the other 33 patients. The levels of hemoglobin (Hb), follicle stimulating hormone (FSH) and ovarian follicle size before and 6 months after the operation was measured. Vaginal bleeding, reintervention, hot flash and cost in both procedures were studied. Results: No significant difference was observed after 6 months between the two groups (P = 0.356). In each group one case with FSH above 10 IU/L was observed. The existence of dominant follicle and the size of it was the same in the two groups (P = 0.390). But the level of Hb was higher in women under embolization 6 months after intervention (P = 0.001). The average level of pain after hysterectomy was higher than embolization. The cost of embolization was 12 times higher than hysterectomy. Conclusion: This study indicated that UAE in young women had no impact on the ovarian reserve and did not increase the level of FSH. Long term studies regarding reproductive assessment and menopausal age in women with history of UEA are necessary. J Clin Gynecol Obstet. 2014;3(2):62-67 doi: http: //dx.doi.o rg/10.14740/jcgo239 w