Internal medicine

Amenorrhea

Hysterectomy

Uterine artery embolization

Biology

Obstetrics

Surgery

Randomized controlled trial

Uterine myomectomy

Uterus

Leiomyoma

Myoma

Uterine artery

Gynecology

Pregnancy

Uterine leiomyoma

Uterine fibroids

Gestation

Genetics

Medicine

International Journal of Gynecology & Obstetrics

To determine treatment options (myomectomy vs. uterine artery embolization (UAE)) for women wishing to avoid hysterectomy.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.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.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.

Effects on heavy menstrual bleeding and pregnancy of uterine artery embolization (<scp>UAE</scp>) or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: The <scp>FEMME</scp> randomized controlled trial

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