The following reviews and commentaries on articles in current medical publications were written by SRS members. Publication of these summaries does not reflect endorsement of any particular procedure or treatment. Views expressed in these summaries do not necessarily reflect the views of SRS or ASRM.
This fibroid focused set of reviews is atypical for SRS in that surgical technique and outcomes are not directly addressed. However, the findings open up important doors for research in reproductive surgery. The recent Shavell article begs the question that if large fibroids are meaningfully detrimental to obstetrical outcomes, should reproductive surgeons be removing them prior to conception in women without infertility? The two recent NEJM articles suggest ulipristal acetate can be used preoperatively for fibroids, although the latter suggests leuprolide may be more effective in reducing fibroid volume. On a parallel note, the included Fertility & Sterility Parsanezhad article demonstrates the efficacy of both triptorelin and letrozole in reducing fibroid volume, though letrozole may be a better choice. Collectively, the three papers on potential preoperative treatment for fibroids invite numerous relevant questions, such as which therapy subjectively best preserves surgical planes for myomectomy, should we be turning to alternatives that have a better side-effect profile and that are more cost-effective than leuprolide, and what is the ideal time for intervention if preoperative fibroid volume reduction is the goal rather than correction of anemia? Components of these answers may appear in the attached articles, but more trials will be needed. It is our hope that this review of recent important articles on fibroids not only provides answers, but inspires exploration of questions that SRS members and readers may some day be answering for all of us.
Steven R. Lindheim
SRS Website Committee Chair
NEW! A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Reviewed by Dr. John Preston Parry, M.D., M.P.H. Comments by Dr. Steven R. Lindheim, M.D.
NEW! Adverse obstetric outcomes associated with sonographically identified large uterine fibroids. Reviewed by Dr. John Preston Parry, M.D., M.P.H. Comments by Dr. Steven R. Lindheim, M.D.
NEW! Ulipristal acetate versus placebo for fibroid treatment before surgery. Reviewed by Dr. John Preston Parry, M.D., M.P.H. Comments by Dr. Steven R. Lindheim, M.D.
NEW! Ulipristal acetate versus leuprolide acetate for uterine fibroids. Reviewed by Dr. John Preston Parry, M.D., M.P.H. Comments by Dr. Steven R. Lindheim, M.D.