• Title/Summary/Keyword: fibroids

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Alterations in uterine hemodynamics caused by uterine fibroids and their impact on in vitro fertilization outcomes

  • Moon, Jei-Won;Kim, Chung-Hoon;Kim, Jun-Bum;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.4
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    • pp.163-168
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    • 2015
  • Objective: To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods: In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results: Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (${\geq}2$) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion: Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids.

A Case Report on 2 Cases of Patients with Uterine Fibroids Observed an Effective Result on Ultrasonography after Korean Traditional Medical Treatment (초음파를 이용하여 관찰한 자궁근종의 한의 치료 경과 고찰 2례 : 증례보고)

  • Gwak, Yu-Jin;Park, Sang-Hee;Jung, Myung-Ju;Park, Sung-Woo;Park, Ung;Jo, Hee-Guen
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.1
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    • pp.147-157
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    • 2015
  • Objectives: We report two cases that have an effective result with Korean traditional medical treatment to two patients who have uterine fibroids, using transabdominal ultrasonography for checking the size of uterine fibroids. Methods: A 44-year-old patient and a 43-year-old patient were treated with an herbal medicine, acupuncture and cupping therapy. We followed up the symptoms and the size of uterine fibroids. Results: The 44-year-old patient was asymptomatic, her size of the uterine fibroid was reduced for 6 months. Also, the 43-year-old patient experienced that the symptoms such as urinary frequency, ovulation pain, heavy bleeding were improved and the size of the uterine fibroid was reduced. Conclusions: This results suggest that Korean traditional medical treatment if effective for both asymptomatic and symptomatic uterine fibroids and ultrasonography is useful for checking the effect of Korean traditional medical treatment. Further case series and studies are warranted.

Ileo-uterine fistula in a degenerated posterior wall fibroid after Caesarean section

  • Shehata, Ayman;Hussein, Naglaa;El Halwagy, Ahmed;El Gergawy, Adel;Khairallah, Mohamed
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.51-53
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    • 2016
  • Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

Medicinal plants traditionally used for the management of female reproductive health dysfunction in Tana River County, Kenya

  • Kaingu, Catherine Kaluwa;Oduma, Jemimah Achieng;Mbaria, James Mucunu;Kiama, Stephen Gitah
    • CELLMED
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    • v.3 no.2
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    • pp.17.1-17.10
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    • 2013
  • Reproductive dysfunction is a major health concern amongst the inhabitants of Tana River County. An ethno botanical study was conducted in Garsen, Itsowe and Ngao sub divisions of Tana River County to document the utilization of medicinal plants for the management of female reproductive ailments. The target population was practicing herbalists from Pokomo, Ormo and Giryama communities in the study area. Structured questionnaires and focussed group discussions were used to collect data. Forty eight plant species distributed in 40 genera and 29 families were documented as being important for the management of pregnancy related complications, menstrual disorders, infertility, fibroids and as contraceptives. The species most frequently cited by the herbalists were fourteen. Fifty two percent of the plant species were probably being mentioned for the first time as being useful in reproductive health management. In conclusion, Tana River has a pool of TMPs with a wealth of indigenous knowledge that needs to be exploited. The plants used to treat dysmenorrhea for example may be important analgesic agents that need further investigation while those with anti-fertility properties may contain steroidal phyto chemical compounds. Such species therefore need further investigation to establish their efficacy and mechanism of action.

Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy

  • Lee, Jae-Yeon;Hwang, Kyu-Ri;Won, Kyu-Hee;Lee, Da-Yong;Jeon, Hye-Won;Moon, Min-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.4
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    • pp.174-177
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    • 2014
  • Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

Induced apoptosis in human Uterine Leiomyoma Cells by treatment with Chiljehyangbu-hwan (칠제향부환(七製香附丸)이 자궁근종세포의 성장억제와 세포자멸사에 미치는 영향)

  • Kim, Seuk-Jung;Beak, Seung-Hee;Kim, En-Ha;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.2
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    • pp.25-42
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    • 2007
  • Purpose : Uterine leiomyoma (fibroids) are benign smooth muscle tumors originating from the myometrium. These benign neoplasms of monoclonal origin are typically diagnosed during the reproductive years, occurring only after puberty and tending to regress after menopause. In the present study we used Chiljehyangbu-hwan to determine its growth inhibitory effect and apoptosis in human uterine leiomyoma cells. Methods : Primary cultured human uterine leiomyoma cells were treated with Chiljehyangbu-hwan. Cell viability analysis was analyzed by MTS assay and FACS was performed to ascertain the effects Chiljehyangbu-hwan. DNA fragmentation analysis and casapase-3 activity test were done. Expression of apoptosis related proteins were evaluated by Western blot analysis. Results : Cell viability was significantly influenced by Chiljehyangbu-hwan treatment in a dose-dependent manner in leiomyoma cells compare to normal myometrial cells. FACS showed that Chiljehyangbu-hwan induced Sub G1 arrest. DNA fragmentation assay was carried out and apoptosis was detected. Activation of caspase-3, down-regulation of Bcl-2, with concomitant increased expression in Bid and Bax were observed. Chiljehyangbu-hwan treatment of uterine leiomyoma cells resulted in a concentration-dependent cell death induced via the mitochondrial pathway.

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Do Women over 35 Years Old Who Have Undergone a Myomectomy Require More Acupuncture Sessions to Become Pregnant?

  • Ajayi, Abayomi B;Ajayi, Tola R;Ejeliogu, Iniobong S;Ajayi, Victor D;Afolabi, Bamgboye M
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.200-206
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    • 2018
  • Background: To evaluate whether ${\geq}3$ adjunct acupuncture sessions accompanying embryo transfer, increases the chance of pregnancy amongst post-myomectomy women aged ${\geq}35$ years. Methods: This was a prospective study carried out at Nordica Fertility Center. Following written informed consent, 75 patients undergoing assisted reproduction therapy and who had good quality embryos, were age-matched and grouped into post-myomectomy (n = 24) and normal women who had no evidence of fibroids or previous myomectomy (n = 51). Between 1 and 3 sessions of acupuncture were performed on 6 post-myomectomy and 19 infertile women who had not undergone myomectomy, while > 3 acupuncture sessions were performed on 18 post-myomectomy and on 32 normal patients, approximately 25 minutes before and after embryo transfer. Results: A positive pregnancy test was defined as ultrasonographic evidence indicating presence of a fetal sac 6 weeks after embryo transfer. Of the 5 post-myomectomy women who were pregnant, only 1 (20.0%) received 1-3 adjunct acupuncture sessions whilst the remaining 4 (80.0%) received > 3 acupuncture sessions. Of the 11 normal pregnant women, 5 (45.4%) received 1-3 adjunct acupuncture sessions while 6 (54.5%) received > 3 adjunct acupuncture sessions. Conclusion: Pregnancy rates in infertile post-myomectomy women may be improved by > 3 adjunct acupuncture sessions.

Serous tubal intraepithelial carcinoma detected during benign gynecologic surgery: a case report

  • Eun Seo Shin;Sung Yob Kim
    • Journal of Medicine and Life Science
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    • v.20 no.1
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    • pp.48-52
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    • 2023
  • High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

The Activity of Proliferating Cell Nuclear Antigen(PCNA) of Uterine Myoma after Treatment with Gonadotropin Releasing Hormone(GnRH) Analogue (자궁근종 환자에서 Gonadotropin Releasing Hormone(GnRH) 유사체 투여 후 자궁근종 세포 증식에 관한 연구)

  • Lee, Byung-Seok;Lee, Bo-Yeon;Park, Ki-Hyun;Cho, Dong-Jae;Lee, Kook;Song, Chan-Ho;Kim, Ho-Keun
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.2
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    • pp.175-179
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    • 1992
  • The factors involved in the initial neoplastic transformation and subsquent growth of uterine fibroid are poorly understood. The reduction in uterine fibroid volume associated with the chronic administration of the mechanisms mediating the decrease in fibroid volume in GnRH-a treated patients are poorly defined. The purpose of this study was to determine the proliferating cell nuclear antigen(PCNA) in fibroid from-women pretreated with GnRH analogue(GnRH-a) compared with controls. Tissue was obtained from 16 premenopausal women with uterine fibroid who received GnRH-a(D-Trp6-GnRH) intramusculary every 28 days for four injections. The mean proliferating index(PI) in patients with uterine fibroids was $2.25{\pm}0.9$, and in controls was $8.82{\pm}1.8$(P<0.001). The proliferating index was not corrleated with the reduction of fibroid volume. In this clinical study, although hypoestrogenism may be the main factor that reduce the volume of fibroid, other factors are also considered to be involved in that process. And the regrowth of uterine fibroid may be affected by increased production of PCNA after stopping GnRH-a.

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