Shrinking leiomyomas by pharmacological autophagy other than surgical removal

Uterine myomas may have significant detrimental effects on menstruation and fertility. Regardless of their location within the uterus, they may reduce the chance of successful embryo implantation (clinical pregnancy) by 50% and increase the risk of pregnancy loss (1). While the negative impact of myomas on fertility seems clear, there is still no strong evidence regarding the influence of their removal on conception. Indeed, the latest Practice Bulletin from 2017 of the Practice Committee of the American Society for Reproductive Medicine (2) concludes that “myomectomy is generally not advised to improve pregnancy outcomes in asymptomatic infertile women with non-cavity‒distorting myomas” but states that it “may be reasonable in some circumstances.”
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research

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AbstractIntroductionOvarian endometriosis is the most common type of endometriosis (EM), affecting more than 40% of women with EM. Currently, surgical intervention is still controversial in infertile patients with ovarian endometriosis, especially in those with stage  III–IV EM. Very few studies have been done to analyze long-term pregnancy results in patients with endometrioma more than 5 years after surgery. Therefore, the aim of this study was to explore the pregnancy outcomes and the related factors in patients with endometrioma and stage III–IV endom etriosis during a long-term follow-up pos...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 30 January 2020Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Meritxell Gracia, Francisco CarmonaAbstractUterine myomas (fibroids, leiomyomas) are the most common benign myometrial tumors in women of reproductive age. They are present in 5-70% of women (depending on different series), with at least one fibroid identified in 70% of women aged 40 to 60 years. Symptoms are present in 20-50% of women with uterine fibroids and include Abnormal Uterine Bleeding (AUB), pelvic pain, Bulk-pressure symptoms and fertility problems depending on the size and ...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Purpose of review To investigate the JZE alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment. Recent findings JZE was found to be significantly extended in patients with endometriosis, leading to the conclusion that endometriosis is a primary disease of the uterus, much like adenomyosis. Statistical correlation was then demonstrated between the severity of endometriosis and the depth of the adenomyosis infiltrates, hence the thickening of the JZE. Stem cells, predominantly found in the JZE were also found in histological sections of leiomyoma, suggested to be the ori...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
Abstract Females with symptomatic leiomyomas (fibroids) wishing to maintain fertility are faced with difficult treatment choices. These include uterine fibroid embolization (UFE), myomectomy, hormonal therapy, MRI high intensity focused ultrasound, and myolysis. This review focuses on UFE, one of the most commonly accepted minimally invasive procedural choices among patients with symptomatic fibroids wishing to retain the option of becoming pregnant in the future, and makes comparisons to myomectomy which has historically been the surgical choice for fertility-preserving fibroid treatment. Pubmed and Google Schola...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
Authors: Bhalani V, Chang A, Adkins C, Chen SH, Scheiber M Abstract OBJECTIVE: To assess fertility outcomes in infertile women after hysteroscopic morcellation of intrauterine lesions. STUDY DESIGN: Retrospective case series from 2 U.S. fertility clinics. Women with intrauterine pathology and infertility (≥6 months' duration if age ≥35, or ≥12 months' duration if age
Source: Journal of Reproductive Medicine - Category: Reproduction Medicine Tags: J Reprod Med Source Type: research
ConclusionFindings of this study showed that risk factors of recurrent abortion, TPO-Ab and uterine leiomyoma have significant importance in pregnant patients undergoing ART.
Source: Middle East Fertility Society Journal - Category: Reproduction Medicine Source Type: research
(Abstracted from Hum Reprod 2017;32(10):2036–2041) Uterine tumors are a public health issue because of their prevalence in women and their connection to menstrual disorders, anemia, pelvis pain, pregnancy loss, and infertility. Treatment of symptomatic fibroids includes open myomectomy or hysterectomy, which have higher morbidity rates, longer hospital stays, and more disruption of daily life.
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Gynecology: Normal and Abnormal Menstrual Cycles Source Type: research
AbstractBACKGROUNDUterine leiomyoma (also known as fibroid or myoma) is the most common benign tumor of the uterus found in women of reproductive age. It is not usually fatal but can produce serious clinical symptoms, including excessive uterine bleeding, pelvic pain or pressure, infertility and pregnancy complications. Due to lack of effective medical treatments surgery has been a definitive choice for the management of this tumor.OBJECTIVE AND RATIONALEExtracellular matrix (ECM) accumulation and remodeling are thought to be crucial for fibrotic diseases such as uterine leiomyoma. Indeed, ECM plays important role in formi...
Source: Human Reproduction Update - Category: OBGYN Source Type: research
The objective of this video presentation is to describe the surgical technique of hysteroscopic myomectomy of a large leiomyoma that was found embedded at the base of a complete uterine septum during hysteroscopic division of the septum. This video focuses on one case of a patient that was undergoing infertility workup due to recurrent pregnancy loss secondary to advanced maternal age and diminished ovarian reserve. Patient underwent operative hysteroscopy for septoplasty, and was found to have a complete uterine septum and during hysteroscopic division was found to have a large fibroids embedded in the septum.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Source Type: research
CONCLUSION: Leiomyoma presence was not associated with increased risk of spontaneous abortion in an analysis of more than 20,000 pregnant women. Failure of prior studies to adjust for confounders may have led to the common clinical belief that leiomyomas are a risk factor for spontaneous abortion. PMID: 29016496 [PubMed - as supplied by publisher]
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
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