Peter Kovacs1, John J Stangel, Nanette F Santoro, Harry Lieman. 1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York 10461, USA. pkovcs@aol.com
Abstract
OBJECTIVE: To report a case of transient ovarian failure after treatment of symptomatic leiomyomata and review other iatrogenic causes of transient ovarian failure. DESIGN: Case report and literature review. SETTING: University-affiliated private practice. PATIENT(S): A 35-year-old woman with symptomatic leiomyomata. INTERVENTION(S): Bilateral uterine artery embolization with subsequent abdominal myomectomy to treat unchanged regular heavy menstrual flow. MAIN OUTCOME MEASURE(S): Ovarian function. RESULT(S): Because medical therapy failed to control her menorrhagia, the patient proceeded with uterine artery embolization. She had persistent menorrhagia after bilateral uterine artery embolization and underwent exploratory laparotomy and myomectomy. After surgery, she had amenorrhea, hot flushes, and elevated FSH levels for 3 months. Ovarian function recovered after a short course of oral contraceptives, and the patient conceived without assistance. CONCLUSION(S): Several interventions can affect normal ovarian function and can lead to permanent or transient ovarian failure. Possible causes of transient ovarian failure are radioactive iodine treatment, radiation, chemotherapy, pelvic surgery, stress, and uterine artery embolization. Before these interventions are applied, the possibility of ovarian failure and available preventive measures should be discussed with the patient.
OBJECTIVE: To report a case of transient ovarian failure after treatment of symptomatic leiomyomata and review other iatrogenic causes of transient ovarian failure. DESIGN: Case report and literature review. SETTING: University-affiliated private practice. PATIENT(S): A 35-year-old woman with symptomatic leiomyomata. INTERVENTION(S): Bilateral uterine artery embolization with subsequent abdominal myomectomy to treat unchanged regular heavy menstrual flow. MAIN OUTCOME MEASURE(S): Ovarian function. RESULT(S): Because medical therapy failed to control her menorrhagia, the patient proceeded with uterine artery embolization. She had persistent menorrhagia after bilateral uterine artery embolization and underwent exploratory laparotomy and myomectomy. After surgery, she had amenorrhea, hot flushes, and elevated FSH levels for 3 months. Ovarian function recovered after a short course of oral contraceptives, and the patient conceived without assistance. CONCLUSION(S): Several interventions can affect normal ovarian function and can lead to permanent or transient ovarian failure. Possible causes of transient ovarian failure are radioactive iodine treatment, radiation, chemotherapy, pelvic surgery, stress, and uterine artery embolization. Before these interventions are applied, the possibility of ovarian failure and available preventive measures should be discussed with the patient.