Fibroids and Reproduction

Cover
Half Title
Title Page
Copyright Page
Contents
Preface
Contributors
1. Fibroids and Reproduction: A Bird’s-Eye View
	Introduction
	Classification
	Diagnosis
	Fertility
	Conception
	Miscarriage
	In Vitro Fertilization Outcome
	References
2. Fibroids and Assisted Reproduction Technology
	Introduction
	Risk Factors
	Classification
	Fibroid and Assisted Reproduction Technology Outcomes: Current Evidence
	Subserosal Fibroids
	Intramural Fibroids
	Submucosal Fibroids
	Treatment of Fibroids from the Fertility Aspect
	Surgical Treatment
		Surgery for Submucosal Fibroids
		Surgery for Intramural Fibroids
		Alternatives to Surgical Interference
			Uterine Artery Embolization
			GnRH Agonists
	Selective Progesterone Receptor Modulators
	Algorithms for Fibroid Management
	Type 0 Myomas
	Type 1 and 2 Myomas
	Types 3 through 5 Myomas (Single or Multiple)
	Conclusion
	References
3. Fibroids and Endometrial Receptivity/Embryo Implantation
	Introduction
	Implantation
		Normal Steps of Implantation
		Endometrial Receptivity
	Fibroids and Endometrial Receptivity
		Mechanical Disruptors
		Disruption of Implantation
		Angiogenic and Vascular Factors
		Immunologic and Inflammatory Factors
		Impact on Gene Expression
	Conclusion
	Research and Future Therapeutics
	References
4. Uterine Fibroids and Recurrent Pregnancy Loss
	Introduction
	Fibroids and Pregnancy Loss
	Fibroids and Recurrent Pregnancy Loss
	Evaluation of Anatomic Factors in Recurrent Pregnancy Loss
	Treatment
		Medical Management
		Procedural Options
		Hysteroscopic Myomectomy
		Laparoscopic and Abdominal Myomectomy
	Conclusion
	References
5. Fibroids in Pregnancy
	Introduction
	Prevalence
	Changes in Size during Pregnancy and Postpartum
	Symptoms
	Complications
	Management Issues
	Management of Patients with Prior Myomectomy
	References
6. Medical Options for Uterine Fibroids in the Context of Reproduction
	Introduction
	Risk Factors of Uterine Fibroids
		Race
		Reproductive Factors
		Obesity
		Vitamin D Deficiency
		Hormonal Effects
	Uterine Fibroid Management
		Hysteroscopic Myomectomy
		Laparoscopic Myomectomy
		Uterine Artery Embolization
		Pharmacological Therapies for Uterine Fibroids
		Combined Oral Contraceptives
		Levonorgestrel-Releasing Intrauterine System
		Progestogens
		Selective Progesterone Receptor Modulators
		Gonadotropin-Releasing Hormone Agonist
		Developing New Medical Treatment for Uterine Fibroids
			Nonpeptide Oral Gonadotropin-Releasing Hormone Antagonists
	Conclusions and Future Directions
	Conflict of Interest
	References
7. Fibroid Preoperative Imaging: Ultrasound
	Introduction
	Ultrasound Technique
		Two-Dimensional Ultrasound
		Three-Dimensional Ultrasound
	Saline Infusion Sonohysterography
		Hysterosalpingo Contrast Sonography
	Color Doppler
		Magnetic Resonance Imaging
	Establishing a Correct Diagnosis via Ultrasound
		Ultrasound Features of Fibroids
		Ultrasound Features of Various Differential Diagnoses
			Adenomyosis
			Diffuse Uterine Leiomyomatosis
			Endometrial Polyps
			Ovarian Fibromas
			Leiomyosarcoma
			Disseminated Peritoneal Leiomyomatosis
	Proper Reporting of Ultrasound Findings
	Conclusion
	References
8. Fibroid Preoperative Imaging: Magnetic Resonance Imaging
	Introduction
	Magnetic Resonance Imaging Techniques
	Magnetic Resonance Imaging Features of Uterine Leiomyomas and Differential Diagnosis
	Classification of Uterine Leiomyomas and Implications for Management
	Conclusion
	References
9. Interventional Procedures
	Introduction
	Uterine Artery Embolization
		Procedure Specifics
		Short-Term Outcomes
		Long-Term Outcomes and Reintervention
		Risks
		Pregnancy Afterward
	Magnetic Resonance–Guided Focused Ultrasound
		Procedure Specifics
		Short-Term Outcomes
		Long-Term Outcomes and Reintervention
		Risks
		Pregnancy Afterward
	Radiofrequency Ablation
		Procedure Specifics
		Short-Term Outcomes
		Long-Term Outcomes and Reintervention
		Risks
		Pregnancy Afterward
	Conclusion
	References
10. Hysteroscopic Myomectomy
	Evolution of Hysteroscopic Myomectomy
	Significance of Submucosal Fibroids
	Preoperative Imaging
	Patient Selection
	Preoperative Considerations (Cervical Ripening, Antibiotics, Venous Thromboembolism Prophylaxis)
	Consents
	Surgical Steps, Intraoperative Considerations, and Complication Prevention
	Instruments, Devices, and Special Techniques
	Office Myomectomy
	Postoperative Care
	Outcomes (Recurrence, Fertility, Adhesions)
	Conclusion
	References
11. Laparoscopic and Robotic-Assisted Myomectomy
	Patient Evaluation and Selection
	Preoperative Management
	Consents and Outcomes
	Preoperative Prophylaxis
	Instrumentation
	Surgical Steps
	Additional Intraoperative Considerations
	Postoperative Care
	Laparoscopically Assisted Myomectomy
	Robotically Assisted Myomectomy
	Intraoperative Ultrasound Guidance
	References
Index