Nancy Nienhaw Hu BS, Abstract Co-Author: Nothing to Disclose

Danielle Kaw, Abstract Co-Author: Nothing to Disclose

Hala Nsouli-Maktabi MPH, Abstract Co-Author: Nothing to Disclose

Michael F McCullough MD, Abstract Co-Author: Nothing to Disclose

James B. Spies MD, Presenter: Nothing to Disclose

To determine if there is a difference in ovarian function and menopausal symptoms of patients undergoing ovarian artery embolization (OAE) supplementing uterine artery embolization (UAE) for leiomyomas compared with those undergoing UAE alone.

We conducted a case-control study at a single university medical center of women undergoing UAE for leiomyomas. Between May 2004 and July 2009, 77 patients (age range 35 to 56) were identified as undergoing unilateral or bilateral OAE during a uterine embolization procedure (cases). Contemporaneous controls, undergoing UAE alone, were identified based on age and race. The patients were queried via mailed or telephone-administered questionnaire regarding the regularity of menstrual cycles, onset of menopause, use of exogenous hormones or if there had been an intervening hysterectomy or other fibroid intervention. Each patient also completed the Menopause Rating Scale (MRS), a validated menopausal symptom questionnaire. Medical records were reviewed to ascertain baseline clinical and procedure data. Cases and controls were compared using appropriate statistics for baseline characteristics and outcomes, with the primary outcome the summary score on the MRS.

Of the total 154 patients contacted, 51 cases and 49 controls responded (65% response rate). Patients exhibited similar baseline findings, with the exceptions that cases presented with larger fibroid volumes (case median 129.3, control median 69.3, P value 0.0252) and longer procedure fluoroscopy times (case mean 20.5, control mean 14, P value <0.0001). There were no differences in menopausal symptoms between the groups (Total MRS scores: case mean 7.4, control mean 8.9, P value = 0.33; United States mean 9.1, lower scores = fewer menopause symptoms). There was no difference in the regularity of menstrual cycles or the frequency of onset of menopause. Of 10 total bilateral OAE cases, 6 responded and all reported having continued menstrual cycles.

OAE in combination with UAE procedure does not precipitate the onset of menopause nor significantly intensify menopausal symptom severity. OAE appears to be a safe adjunct to UAE.

Despite fears that OAE supplementing UAE may cause the onset of menopause and related symptoms, these results suggest clinical signs of ovarian injury after OAE are no more common than in routine UAE.

Hu, N, Kaw, D, Nsouli-Maktabi, H, McCullough, M, Spies, J, Ovarian Artery Embolization Supplementing Uterine Artery Embolization for Leiomyomas: Does It Affect Ovarian Function More Commonly than Routine Uterine Artery Embolization?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002625.html