Selective progesterone receptor modulators for fertility preservation in women with symptomatic uterine fibroids

Mohamed Ali, Ayman Al-Hendy

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Uterine fibroids (UFs, AKA leiomyoma) are the most important benign neoplastic threat to women's health, with costs up to hundreds of billions of health care dollars worldwide. Uterine fibroids caused morbidities exert a tremendous health toll, impacting the quality of life of women of all ethnicities, especially women of color. Clinical presentations include heavy vaginal bleeding, pelvic pain, bulk symptoms, subfertility, and obstetric complications. Current management strategies heavily lean toward surgical procedures; nonetheless, the choice of treatment is generally subject to patient's age and her desire to preserve future fertility. Women with UF who desire to maintain future fertility potential face a dilemma because of the limited treatment choices that are currently available to help them achieve that goal. Recently, ulipristal acetate the first of the promising family of oral selective progesterone receptor modulators has been approved for UF treatment in Europe, Canada, and several other countries and is under review for possible approval in the USA. In this review article, we discuss recent advances in the management options against UF with a bend toward oral effective long-term treatment alternatives who are particularly suited for those seeking to preserve their future fertility potential. We also explore the transformative concept of primary and secondary UF prevention using these new anti-UF agents. We envision a remarkable shift in the management of UF in future years from surgical/invasive treatment to orally administrated options; clearly, this potential shift will require additional intense clinical research.

Original languageEnglish (US)
Pages (from-to)337-352
Number of pages16
JournalBiology of reproduction
Volume97
Issue number3
DOIs
StatePublished - Jan 1 2017

Fingerprint

Fertility Preservation
Leiomyoma
Progesterone Receptors
Fertility
Therapeutics
Pelvic Pain
Uterine Hemorrhage
Women's Health
Secondary Prevention
Health Care Costs
Infertility
Obstetrics
Canada
Color
Quality of Life
Morbidity
Delivery of Health Care
Health
Research

Keywords

  • Fertility preservation
  • Prevention
  • Selective progesterone receptor modulators
  • Treatment
  • Ulipristal acetate
  • Uterine fibroids

ASJC Scopus subject areas

  • Reproductive Medicine
  • Cell Biology

Cite this

Selective progesterone receptor modulators for fertility preservation in women with symptomatic uterine fibroids. / Ali, Mohamed; Al-Hendy, Ayman.

In: Biology of reproduction, Vol. 97, No. 3, 01.01.2017, p. 337-352.

Research output: Contribution to journalReview article

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