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28 August 2017 Selective progesterone receptor modulators for fertility preservation in women with symptomatic uterine fibroids
Mohamed Ali, Ayman Al-Hendy
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Abstract

Uterine fibroids (UFs, AKA leiomyoma) are the most important benign neoplastic threat to women's health, with costs up to hundreds of billions of health care dollars worldwide. Uterine fibroids caused morbidities exert a tremendous health toll, impacting the quality of life of women of all ethnicities, especially women of color. Clinical presentations include heavy vaginal bleeding, pelvic pain, bulk symptoms, subfertility, and obstetric complications. Current management strategies heavily lean toward surgical procedures; nonetheless, the choice of treatment is generally subject to patient's age and her desire to preserve future fertility. Women with UF who desire to maintain future fertility potential face a dilemma because of the limited treatment choices that are currently available to help them achieve that goal. Recently, ulipristal acetate the first of the promising family of oral selective progesterone receptor modulators has been approved for UF treatment in Europe, Canada, and several other countries and is under review for possible approval in the USA. In this review article, we discuss recent advances in the management options against UF with a bend toward oral effective long-term treatment alternatives who are particularly suited for those seeking to preserve their future fertility potential. We also explore the transformative concept of primary and secondary UF prevention using these new anti-UF agents. We envision a remarkable shift in the management of UF in future years from surgical/invasive treatment to orally administrated options; clearly, this potential shift will require additional intense clinical research.

Summary Sentence

We focus on oral long term anti-UF treatment options which can benefit those seek to preserve future fertility. We explore the transformative concept of primary/secondary UF prevention using these agents. We envision a futuristic shift in the UF management from invasive treatment to oral one.

© The Authors 2017. Published by Oxford University Press on behalf of Society for the Study of Reproduction. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Mohamed Ali and Ayman Al-Hendy "Selective progesterone receptor modulators for fertility preservation in women with symptomatic uterine fibroids," Biology of Reproduction 97(3), 337-352, (28 August 2017). https://doi.org/10.1093/biolre/iox094
Received: 21 March 2017; Accepted: 23 August 2017; Published: 28 August 2017
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