With the advent of selective progesterone receptor modulators, what is the place of myoma surgery in current practice? Jacques Donnez, M.D., Ph.D., Olivier.

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Presentation transcript:

With the advent of selective progesterone receptor modulators, what is the place of myoma surgery in current practice? Jacques Donnez, M.D., Ph.D., Olivier Donnez, M.D., Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D. Fertility and Sterility Volume 102, Issue 3, Pages 640-648 (September 2014) DOI: 10.1016/j.fertnstert.2014.06.041 Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 1 FIGO classification of myomas (Munro et al., 2011 [27]). Fertility and Sterility 2014 102, 640-648DOI: (10.1016/j.fertnstert.2014.06.041) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Algorithm for patients <40 years of age presenting with symptomatic myomas and infertility. Fertility and Sterility 2014 102, 640-648DOI: (10.1016/j.fertnstert.2014.06.041) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Algorithm for patients presenting with symptomatic myomas but no desire for pregnancy, who wish to keep their uterus. Fertility and Sterility 2014 102, 640-648DOI: (10.1016/j.fertnstert.2014.06.041) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Very significant decrease in myoma size after four courses of 3 months in a young woman of 20 years. (A) Before multiple myoma treatment (baseline). The uterine cavity is distorted. (B) After four courses of 3 months (UPA 10 mg/d). The uterine cavity and Hb level are now normal. There is a significant reduction in myoma size. As the patient is free of symptoms but does not wish to conceive, surgery may be avoided or at least postponed until pregnancy is desired. Fertility and Sterility 2014 102, 640-648DOI: (10.1016/j.fertnstert.2014.06.041) Copyright © 2014 American Society for Reproductive Medicine Terms and Conditions