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

Authors

  • Mathieu Luyckx Cliniques Universitaires Saint-Luc; Brussels, Belgium
  • Jean-luc Squifflet Cliniques Universitaires Saint-Luc; Brussels, Belgium
  • Pascale Jadoul Cliniques Universitaires Saint-Luc; Brussels, Belgium
  • Rafaella Votino Cliniques Universitaires Saint-Luc; Brussels, Belgium
  • Marie-M. Dolmans Cliniques Universitaires Saint-Luc; Pole de Recherche en Gynecologie, Institut de Recherche Experimentale et Clinique, Universite Catholique de Louvain; Brussels, Belgium
  • Jacques Donnez Societe de Recherche pour l’Infertilite, Brussels, Belgium

DOI:

https://doi.org/10.18370/2309-4117.2014.19.79-84

Keywords:

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

Abstract

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).

Author Biographies

Mathieu Luyckx, Cliniques Universitaires Saint-Luc; Brussels

M.D., Gynecology Department

Jean-luc Squifflet, Cliniques Universitaires Saint-Luc; Brussels

M.D., Ph.D., Gynecology Department

Pascale Jadoul, Cliniques Universitaires Saint-Luc; Brussels

M.D., Gynecology Department

Rafaella Votino, Cliniques Universitaires Saint-Luc; Brussels

M.D., Gynecology Department

Marie-M. Dolmans, Cliniques Universitaires Saint-Luc; Pole de Recherche en Gynecologie, Institut de Recherche Experimentale et Clinique, Universite Catholique de Louvain; Brussels

M.D., Ph.D., Gynecology Department

Jacques Donnez, Societe de Recherche pour l’Infertilite, Brussels

M.D., Ph.D.

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. te Velde E., Pearson P.
  9. «The variability of female reproductive ageing.» Hum Reprod Update, 8(2002):141-54.
  10. 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.
  11. Donnez J., Jadoul P. «What are the implications of myomas on fertility? A need for a debate?» Hum Reprod, 17(2002):1424-30.
  12. 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.
  13. Dubuisson J.B., Fauconnier A., Babaki-Fard K., Chapron C. «Laparoscopic myomectomy: a current view.» Hum Reprod Update, 6(2000):588-94.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. 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.
  19. Sibai B., Dekker G., Kupferminc M. «Pre-eclampsia.» Lancet, 365(2005):785-99.
  20. 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.
  21. Robson W., Leung A., Rogers R. «Unilateral renal agenesis.» Adv Pediatr, 42(1995):575-92.
  22. 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.
  23. 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.
  24. 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.
  25. Gemzell-Danielsson K., Rabe T., Cheng L. «Emergency contraception.» Gynecol Endocrinol, 29(2013):1-14.
  26. 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.

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Published

2014-10-20

How to Cite

Luyckx, M., Squifflet, J.- luc, Jadoul, P., Votino, R., Dolmans, M.-M., & Donnez, J. (2014). First series of 18 pregnancies after ulipristal acetate treatment for uterine fibroids. REPRODUCTIVE ENDOCRINOLOGY, (19), 79–84. https://doi.org/10.18370/2309-4117.2014.19.79-84

Issue

No. 19 (2014)

Section

Tumors and pretumoral pathology

License

Copyright (c) 2015 Mathieu Luyckx, Jean-luc Squifflet, Pascale Jadoul, Rafaella Votino, Marie-M. Dolmans, Jacques Donnez

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