REPRODUCTIVE HEALTH IN THE CONTEXT OF UTERINE FIBROIDS TREATMENT OPTIONS

Authors:

Abstract:

The purpose of this study was to compare the hormonal, endometrial, ultrasonographic, and Doppler changes after six-month postoperative adjuvant treatment (ulipristal acetate and a levonorgestrel-releasing intrauterine system) in women of reproductive age after myomectomy for uterine fibroids. Sixty women with uterine fibroids who underwent myomectomy (study group) and 30 women without uterine pathology as controls have been examined. After surgery, 30 patients received ulipristal acetate at a dose of 5 mg daily for two 3-month courses (subgroup A), while 30 patients were treated with a levonorgestrel-releasing intrauterine system (Subgroup B). Before and after six months of treatment, endometrial thickness, uterine dimensions, uterine volume, resistance index, and serum concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, and progesterone were assessed. ELISA method using the Access 2 Beckman Coulter automated biochemical analyzer was used for hormone levels identification, while ER7-4D ultrasound system – to assess endometrial parameters. In the ulipristal acetate group, endometrial thickness increased from 6.0±0.23 to 9.9±0.21 mm (p<0.001), while estradiol, prolactin, and progesterone decreased significantly. Uterine volume decreased by 15.9 %, and the resistance index decreased from 0.93 to 0.72 (p<0.05). In the levonorgestrel-releasing intrauterine system group, endometrial thickness decreased from 6.3±0.45 to 5.0±0.19 mm, estradiol and progesterone decreased, and prolactin increased slightly. Uterine volume decreased by 13.4 %, and the resistance index decreased from 0.92 to 0.70 (p<0.05). Changes in linear uterine dimensions were not statistically significant in either group. Ulipristal acetate produced a more favorable six-month endometrial and hormonal profile, whereas the levonorgestrel-releasing intrauterine system provided comparable reductions in uterine volume and vascular resistance but was associated with endometrial thinning. Treatment selection should therefore be individualized according to reproductive plans, the need for contraception, and the primary therapeutic goal.

Keywords:

uterine fibroids reproductive age ulipristal acetate levonorgestrel–releasing intrauterine system abnormal uterine bleeding adjuvant therapy endometrial thickness fertility planning

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Publication:

«World of Medicine and Biology» Vol. 22 No. 96 (2026) , с. 22-25
УДК 618.11–006.36–085.2:618.177

DOI:

https://doi.org/10.26724/2079-8334-2026-2-96-22-25