Effects of utero-ovarian anastomoses on basal follicle-stimulating hormone level change after uterine artery embolization with tris-acryl gelatin microspheres

J Vasc Interv Radiol. 2006 Jun;17(6):965-71. doi: 10.1097/01.RVI.0000220425.23309.15.

Abstract

Purpose: To assess the prevalence of anastomoses between uterine and ovarian arteries on angiography and their impact on changes in basal follicle-stimulating hormone (FSH) level after uterine artery embolization (UAE).

Materials and methods: Consecutive premenopausal women who underwent UAE for symptomatic uterine leiomyomata according to a uniform embolization technique with tris-acryl gelatin microspheres at a single institution were included in the study. Basal FSH levels before UAE and 6 months after UAE were compared for patients with and without anastomoses between uterine and ovarian arteries on angiography.

Results: Among 124 patients included in the study (mean age, 43.1+/-5.7 years), patent anastomoses between the uterine and ovarian arteries were detected by angiography in 55 patients (44.4%). Overall, 11.3% of 124 patients showed an increase in basal serum FSH level of greater than 20 mIU/mL after UAE. In patients with utero-ovarian anastomoses, 18.2% showed an increase of greater than 20 mIU/mL after UAE, compared with 5.8% of patients without such anastomoses (P=.03). Mean basal FSH increase after UAE in patients with anastomoses was 8.4+/-20.2 mIU/mL, compared with 2.7+/-10.6 mIU/mL in patients without anastomoses (P=.047). Among patients with anastomoses, the 50- to 54-year age group had the highest percentage of patients with an FSH increase greater than 20 mIU/mL (50.0%) after UAE, followed by patients in the 45- to 49-year age group (15.4%).

Conclusions: Angiographically detected anastomoses between the uterine artery and the ovarian artery are not uncommon. UAE in patients with anastomoses is associated with a greater risk of significant increase of basal FSH level than in UAE in patients without anastomoses. The pathophysiologic processes resulting in change of FSH level may be a reflection of diminished ovarian function, but further study is warranted to delineate the precise mechanism.

MeSH terms

  • Acrylic Resins / therapeutic use
  • Angiography, Digital Subtraction
  • Arteriovenous Anastomosis / diagnostic imaging*
  • Embolization, Therapeutic / methods*
  • Female
  • Follicle Stimulating Hormone / blood*
  • Gelatin / therapeutic use
  • Humans
  • Leiomyoma / blood
  • Leiomyoma / therapy*
  • Middle Aged
  • Ovary / blood supply*
  • Ovary / metabolism
  • Premenopause
  • Treatment Outcome
  • Uterine Neoplasms / blood
  • Uterine Neoplasms / therapy*
  • Uterus / blood supply*
  • Uterus / metabolism

Substances

  • Acrylic Resins
  • trisacryl gelatin microspheres
  • Gelatin
  • Follicle Stimulating Hormone