Experience of managing pregnancy after in vitro fertilization and its outcome in a patient with uterine leiomyoma and a history of uterine artery embolization
Ziganshin A.M., Dikke G.B., Yanbarisova A.R., Frolov A.L., Karimova A.U.
The average age of onset of uterine leiomyoma (UL) is currently 32 years, with an incidence of secondary infertility of 25-56%; this is frequently managed by in vitro fertilization (IVF).
Case report: A 40-year-old patient with multiple UL accompanied by heavy menstrual bleeding, dysmenorrhea and moderate anemia presented for a history of tuboperitoneal infertility lasting for 9 years. There were two childbirths (spontaneous vaginal delivery and caesarean section), missed miscarriage, left adnexectomy, myomectomy, dissection of intrauterine synechiae, two IVF attempts (one ended in a full-term delivery) in the patient’s history. Due to the severity of UL symptoms, uterine artery embolization (UAE) was performed. The volume of UL was reduced by 32%. The patient underwent IVF and fresh embryo transfer, but pregnancy did not occur; after that cryopreserved/thawed embryo transfer was performed. The patient became pregnant, the course of the pregnancy was unremarkable; there was a caesarean section and a live birth of a female fetus weighing 3500g, 7/8 Apgar score. The postoperative period proceeded without complications, and the child develops normally.
Conclusion: UAE for symptomatic UL and infertility in combination with oocyte/embryo cryopreservation and IVF may be a promising method for achieving pregnancy in women with a burdened medical history.
Authors’ contributions: Ziganshin A.M., Frolov A.L. – developing the concept; Yanbarisova A.R., Karimova A.U. – collecting and processing the material; Yanbarisova A.R., Dikke G.B. – writing the text; Ziganshin A.M., Dikke G.B. – editing the article.
Conflicts of interest: The authors declare that there is no conflict of interest and guarantee that the article is the original work of the authors.
Funding: The study was conducted without sponsorship.
Ethical Approval: IVF in a patient who underwent uterine artery embolization was approved by the Ethical Review Board of the Republican Clinical Perinatal Centre, Ufa.
Patient Consent for Publication: The patient signed informed consent for the publication of her data in anonymized form.
For citation: Ziganshin A.M., Dikke G.B., Yanbarisova A.R., Frolov A.L., Karimova A.U.
Experience of managing pregnancy after in vitro fertilization and its outcome in
a patient with uterine leiomyoma and a history of uterine artery embolization.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (11): 229-234 (in Russian)
https://dx.doi.org/10.18565/aig.2024.275
Keywords
uterine leiomyoma
uterine artery embolization
myomectomy
in vitro fertilization
assisted reproductive technologies
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Received 31.10.2024
Accepted 13.11.2024
About the Authors
Aidar M. Ziganshin, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia,450008, Russia, Ufa, Lenin str., 3, Zigaidar@yandex.ru, https://orcid.org/0000-0001-5474-1080
Galina B. Dikke, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology with a course in Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, 190013, Russia, St. Petersburg, Moskovsky Ave., 22, letter M, galadikke@yandex.ru, https://orcid.org/0000-0001-9524-8962
Aliya R. Yanbarisova, Resident at the Department of Obstetrics and Gynecology No. 2, Bashkir State Medical University, Ministry of Health of Russia, 450008, Russia, Ufa, Lenin str., 3, yanbarisova1999@mail.ru, https://orcid.org/0000-0003-3799-4080
Alexey L. Frolov, PhD, Honored Physician of the Russian Federation, Head of the Operating Department No. 2, Republican Clinical Perinatal Center, Ministry of Health
of the Republic of Bashkortostan, 450106, Russia, Ufa, Batyrskaya str., 41, frolrpc@yandex.ru, https://orcid.org/0009-0004-0678-1503
Aliya U. Karimova, Obstetrician-Gynecologist, Reproductologist, Oncologist, "Family" Medical Center, 450054, Russia, Ufa, Prospekt Oktyabrya str., 73, build. 1,
k-aliya@mail.ru, https://orcid.org/0000-0001-5755-5881
Corresponding author: Aliya R. Yanbarisova, yanbarisova1999@mail.ru
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