Fertility After Uterine Artery Embolization

Study Overview
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Brief Summary
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Uterine leiomyomas (or fibroids) are a common disease (30% of women over 35 years of age) in women of childbearing age and can cause various symptoms such as menometrorrhagia, dysmenorrhoea, pelvic pain and heaviness, and infertility. Uterine artery embolisation, first used in France in 1990, is a safe, effective and less invasive therapeutic technique than surgical treatment (myomectomy or hysterectomy), particularly in the case of numerous and large fibroids. This technique is validated by the French National College of Gynaecologists-Obstetricians (CNGOF) as an alternative treatment for women who do not wish to become pregnant (grade A recommendation), but at present there is little reliable data concerning fertility, the occurrence of pregnancy and the obstetrical prognosis after uterine artery embolisation for fibroids. A recent systematic review of the literature with meta-analysis published very recently showed that 40.5% of patients with a desire for pregnancy were able to become pregnant after embolisation (CI: 33.3%-48.2%) but that the rates of miscarriage, obstetric complications and low birth weight were not negligible (respectively 33.5% (95% CI: 26.3-41%), 25.4% (95% CI = 13-40.2%) and 10% (95% CI = 6.2-14.6%) (Ghanaati et al. 2020). In France, uterine artery embolisation is performed in more than thirty centres in women who have completed their parental project. On the other hand, in the absence of consistent literature, it is performed in patients of childbearing age, when it represents the only acceptable alternative or in the event of contraindication or refusal of surgery by the patient. To our knowledge, there is no large-scale French study to date on the impact of embolisation on fertility and pregnancy outcomes. The aim of this study is to compile a retrospective database of all cases of uterine artery embolisation for uterine pathology performed at the Georges-Pompidou European Hospital (HEGP) since 2007 and to assess the impact of embolisation on fertility in patients of childbearing age.

Official Title
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Uterine Artery Embolization For Uterine Pathology: What Impact On Fertility?

Conditions
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Fertility Disorders, Fertility Issues, Myoma;Uterus, Uterine Artery Embolisation

Intervention / Treatment
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* Other: Retrospective data collection
* Other: Phone interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women ≥ 18 years, ≤ 45 years at the time of their embolisation Uterine pathology responsible for disabling symptoms: uterine leiomyomas with no limitations in size, number or location, adenomyosis Having had a uterine artery embolisation between 2007 and September 2020 Minimum delay of one year after embolisation Information and no opposition from patients Exclusion Criteria: Women < 18 years and > 45 years at the time of embolisation Uterine artery embolisation for delivery haemorrhage Patients under court protection, guardianship or curatorship Refusal to participate in this research

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Female who underwent uterine artery embolisation for uterine pathology<br> | Other: Retrospective data collection<br>* Data collection from the medical file of the patients<br>Other: Phone interview<br>* Call for collecting fertility data and obstetrical issues of the patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of live births after embolisation | Rate of live births after embolisation (percentage) | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Obstetrical outcomes after embolisation | Pregnancy rate (percentage) ; Miscarriage rate (percentage) ; Assisted reproduction rate; Obstetric complication rates (haemorrhage, caesarean section, prematurity, pre-eclampsia, placental disorders) | one year | 
| Effectiveness and safety of embolisation | Complication rate of embolisation (percentage) Post-embolisation myomectomy and hysterectomy rates (percentage) | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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uterine artery embolisation, Fertility Issues, Fertility Disorders, uterine myoma