First series of 18 pregnancies after ulipristal acetate treatment for uterine fibroids

Mathieu Luyckx, Jean-luc Squifflet, Pascale Jadoul, Rafaella Votino, Marie-M. Dolmans, Jacques Donnez


Design: Retrospective analysis of a series of 52 patients prospectively included in the PGL4001 (ulipristal acetate) Effi cacy Assessment in Reduction of Symptoms Due to Uterine Leiomyomata (PEARL) II and III trials.

Setting: Academic hospital.

Patient(s): Among the 52 patients, 21 wished to conceive upon treatment completion.

Intervention(s): None.

Main Outcome Measure(s): Pregnancy rate and live birth rate.

Result(s): Twenty-one patients attempted to get pregnant, amongwhom15 (71%) succeeded, totaling 18 pregnancies. Among these 18 pregnancies, 12 resulted in the birth of 13 healthy babies and 6 ended in early miscarriage. No regrowth of fi broids was observed during pregnancy.

Conclusion(s): We report the fi rst series of pregnancies achieved after UPA treatment. Our data confi rm a sustained long-term eff ect after UPA therapy. (Fertil Steril®, 2014. by American Society for Reproductive Medicine).


Fibroids; selective progesterone receptor modulators (SPRMs); ulipristal acetate; рregnancy


Donnez J., Tatarchuk T.F., Bouchard P., Puscasiu L., Zakharenko N.F., Ivanova T. et al. «Ulipristal acetate versus placebo for fi broid treatement before surgery.» N Engl J Med., 366(2012):409-20.

Donnez J., Tomaszewski J., Vazquez F., Bouchard P., Lemieszczuk B., Baro’ F. et al. «Ulipristal acetate versus leuprolide acetate for uterine fi broids.» N Engl J Med., 366(2012):421-31.

Musallam K., Tamim H., Richards T., Spahn D.R., Rosendaal F.R., Habbal A. et al. «Preoperative anemia and post-operative outcomes in non-cardiac surgery: a retrospective cohort study.» Lancet, 378(2011):1396-407.

Williams A.R., Bergeron C., Barlow D.H., Ferenczy A. «Endometrial morphology after treatment of uterine fi broids with the selective progesterone receptor modulator, ulipristal acetate.» Int J Gynecol Pathol, 31(2012):556-69.

Donnez J., Vazquez F., Tomaszewski T., Nouri K., Bouchard P., Fauser B.C. et al. «Long-term treatment of uterine fi broids with ulipristal acetate.» Fertil Steril, 101(2014):1565-73.e1-18.

Donnez J., Donnez O., Dolmans M.M. «With the advent of SPRMs, what is the place of myoma surgery in current practice?» Fertil Steril, 102(2014):640-8.

Munro M.G., Critchley H.O., Fraser I.S. «The FIGO classifi cation of causes of abnormal uterine bleeding.» Int J Gynaecol Obstet, 113(2011):1-2.

te Velde E., Pearson P.

«The variability of female reproductive ageing.» Hum Reprod Update, 8(2002):141-54.

Ferraretti A.P., Goossens V., Kupka M., Bhattacharya S., de Mouzon J., Castilla J.A. et al. «Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE.» Hum Reprod, 28(2013):2318-31.

Donnez J., Jadoul P. «What are the implications of myomas on fertility? A need for a debate?» Hum Reprod, 17(2002):1424-30.

Kayem G., Raiff ort C., Legardeu H., Gavard L., Mandelbrot L., Girard G. et al. «Specifi c particularities of uterine scars and their impact on the risk of uterine rupture in case of trial of labor.» J Gynecol Obstet Biol Reprod (Paris) 41(2012):753-71.

Dubuisson J.B., Fauconnier A., Babaki-Fard K., Chapron C. «Laparoscopic myomectomy: a current view.» Hum Reprod Update, 6(2000):588-94.

Jin C., Hu Y., Chen X.C., Zheng F.Y., Lin F., Zhou K. et al. «Laparoscopic versus open myomectomy – a meta-analysis for randomized controlled trials.» Eur J Obstet Gynecol Reprod Biol., 145(2009):14-21.

Kim M., Uhm Y., Kim J., Jee B.C., Kim Y.B. «Obstetrics outcomes after uterine myomectomy: laparoscopic versus laparotomic approach.» Obstet Gynecol Sci, 56(2013):375-81.

Nisolle M., Gillerot S., Casanas-Roux F., Squiffl et J., Berliere M., Donnez J. «Immunohistochemical study of the proliferation index, oestrogen receptors and progesterone receptors A and B in leiomyomata and normal myometrium during the menstrual cycle and under gonadotrophin-releasing hormone agonist therapy.» Hum Reprod, 14(1999):2844-50.

Islam M.S., Protic O., Stortoni P., Grechi G., Lamanna P., Petraglia F. et al. «Complex networks of multiple factors in the pathogenesis of uterine leiomyoma.» Fertil Steril, 100(2013):178-93.

Islam M.S., Protic O., Giannubilo S.R., Toti P., Tranquilli A.L., Petraglia F. et al. «Uterine leiomyoma: available medical treatments and new possible therapeutic options.» J Clin Endocrinol Metab, 98(2013):921-34.

Sibai B., Dekker G., Kupferminc M. «Pre-eclampsia.» Lancet, 365(2005):785-99.

Carritis S., Sibai B., Haulth J., Lindheimer M.D., Klebanoff M., Thom E. et al. «Low-dose aspirin to prevent preeclampsia in women at high risk.» N Engl J Med., 388(1998):701-5.

Robson W., Leung A., Rogers R. «Unilateral renal agenesis.» Adv Pediatr, 42(1995):575-92.

Faa G., Gerosa C., Fanni D., Monga G., Zaff anello M., Van Eyken P. et al. «Review morphogenesis and molecular mechanisms involved in human kidney development.» J Cell Physiol, 227(2012):1257-68.

Chai O.H., Song C.H., Park S.K., Kim W., Cho E.S. «Molecular regulation of kidney development.» Anat Cell Biol., 46(2013):19-31.

Bernard N., Elefant E., Carlier P., Tebacher M., Barjhoux C.E., Bos-Thompson M.A. et al. «Continuation of pregnancy after fi rst-trimester exposure to mifepristone: an observational prospective study.» BJOG, 120(2013):568-74.

Gemzell-Danielsson K., Rabe T., Cheng L. «Emergency contraception.» Gynecol Endocrinol, 29(2013):1-14.

Mutter G.L., Bergeron C., Deligdisch L., Ferenczy A., Glant M., Merino M. et al. «The spectrum of endometrial pathology induced by progesterone receptor modulators.» Mod Pathol, 21(2008):591-8.

GOST Style Citations

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)