Uterine Fibroids

Key clinical point: Hereditary leiomyomatosis and renal cell cancer (HLRCC) can be distinguished from sporadic uterine leiomyomas (ULs) by clinical characteristics and morphologic features of fumarate hydratase (FH)-mutant leiomyomas aided by Bcl-2 and CD34 immunohistochemistry.

Major finding: Women with HLRCC vs. sporadic ULs were significantly younger (33.8 years vs 45.4 years), more frequently symptomatic (95% vs 6.5%), and had numerous ULs (more than 4 tumors, 88.9% vs 30.8%; all P < .0001). Stronger Bcl-2 staining (P = .003) and higher microvessel density highlighted by CD34 immunostaining (P < .0001) distinguished HLRCC-related leiomyomas from sporadic leiomyomas.

Study details: Findings are from a nationwide study including 20 women with a known FH germline mutation and 77 women with sporadic ULs.

Disclosures: This study was supported by the Academy of Finland, Sigrid Jusélius Foundation, Cancer Society of Finland, and Finnish Medical Foundation. The authors declared no conflict of interests.

Source: Uimari O et al. Acta Obstet Gynecol Scand. 2021 Sep 3. doi: 10.1111/aogs.14248.

Key clinical point: Hereditary leiomyomatosis and renal cell cancer (HLRCC) can be distinguished from sporadic uterine leiomyomas (ULs) by clinical characteristics and morphologic features of fumarate hydratase (FH)-mutant leiomyomas aided by Bcl-2 and CD34 immunohistochemistry.

Major finding: Women with HLRCC vs. sporadic ULs were significantly younger (33.8 years vs 45.4 years), more frequently symptomatic (95% vs 6.5%), and had numerous ULs (more than 4 tumors, 88.9% vs 30.8%; all P < .0001). Stronger Bcl-2 staining (P = .003) and higher microvessel density highlighted by CD34 immunostaining (P < .0001) distinguished HLRCC-related leiomyomas from sporadic leiomyomas.

Study details: Findings are from a nationwide study including 20 women with a known FH germline mutation and 77 women with sporadic ULs.

Disclosures: This study was supported by the Academy of Finland, Sigrid Jusélius Foundation, Cancer Society of Finland, and Finnish Medical Foundation. The authors declared no conflict of interests.

Source: Uimari O et al. Acta Obstet Gynecol Scand. 2021 Sep 3. doi: 10.1111/aogs.14248.

Key clinical point: Hereditary leiomyomatosis and renal cell cancer (HLRCC) can be distinguished from sporadic uterine leiomyomas (ULs) by clinical characteristics and morphologic features of fumarate hydratase (FH)-mutant leiomyomas aided by Bcl-2 and CD34 immunohistochemistry.

Major finding: Women with HLRCC vs. sporadic ULs were significantly younger (33.8 years vs 45.4 years), more frequently symptomatic (95% vs 6.5%), and had numerous ULs (more than 4 tumors, 88.9% vs 30.8%; all P < .0001). Stronger Bcl-2 staining (P = .003) and higher microvessel density highlighted by CD34 immunostaining (P < .0001) distinguished HLRCC-related leiomyomas from sporadic leiomyomas.

Study details: Findings are from a nationwide study including 20 women with a known FH germline mutation and 77 women with sporadic ULs.

Disclosures: This study was supported by the Academy of Finland, Sigrid Jusélius Foundation, Cancer Society of Finland, and Finnish Medical Foundation. The authors declared no conflict of interests.

Source: Uimari O et al. Acta Obstet Gynecol Scand. 2021 Sep 3. doi: 10.1111/aogs.14248.

Key clinical point: Ovarian arteries embolization (OAE) improved quality of life (QoL) and lowered rates of subsequent surgery in women who experienced persistent symptoms after uterine arteries embolization (UAE) for uterine fibroids (UF).

Major finding: Less than a fifth of the cohort underwent subsequent hysterectomy. Almost 90.9% of patients who underwent magnetic resonance imaging after 12 months of OAE showed a decrease in uterine volume and complete devascularization of the dominant fibroid tumor. After a mean follow-up of 70 months, 8 of the 10 patients who responded to the QoL questionnaire reported an improvement or stability of symptoms.

Study details: Findings are from a retrospective analysis of 1,300 women treated with UAE for symptomatic UF, of which 18 women underwent a second embolization through one or both ovarian arteries.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ifergan H et al. Abdom Radiol (NY). 2021 Aug 25. doi: 10.1007/s00261-021-03255-w.

Key clinical point: Ovarian arteries embolization (OAE) improved quality of life (QoL) and lowered rates of subsequent surgery in women who experienced persistent symptoms after uterine arteries embolization (UAE) for uterine fibroids (UF).

Major finding: Less than a fifth of the cohort underwent subsequent hysterectomy. Almost 90.9% of patients who underwent magnetic resonance imaging after 12 months of OAE showed a decrease in uterine volume and complete devascularization of the dominant fibroid tumor. After a mean follow-up of 70 months, 8 of the 10 patients who responded to the QoL questionnaire reported an improvement or stability of symptoms.

Study details: Findings are from a retrospective analysis of 1,300 women treated with UAE for symptomatic UF, of which 18 women underwent a second embolization through one or both ovarian arteries.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ifergan H et al. Abdom Radiol (NY). 2021 Aug 25. doi: 10.1007/s00261-021-03255-w.

Key clinical point: Ovarian arteries embolization (OAE) improved quality of life (QoL) and lowered rates of subsequent surgery in women who experienced persistent symptoms after uterine arteries embolization (UAE) for uterine fibroids (UF).

Major finding: Less than a fifth of the cohort underwent subsequent hysterectomy. Almost 90.9% of patients who underwent magnetic resonance imaging after 12 months of OAE showed a decrease in uterine volume and complete devascularization of the dominant fibroid tumor. After a mean follow-up of 70 months, 8 of the 10 patients who responded to the QoL questionnaire reported an improvement or stability of symptoms.

Study details: Findings are from a retrospective analysis of 1,300 women treated with UAE for symptomatic UF, of which 18 women underwent a second embolization through one or both ovarian arteries.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ifergan H et al. Abdom Radiol (NY). 2021 Aug 25. doi: 10.1007/s00261-021-03255-w.

Key clinical point: The surgical approach for removal of uterine fibroids should consider the number and size of fibroids, surgical time, and reproductive diagnosis with minimally invasive routes offered whenever possible because of its better outcome on achieving pregnancy.

Major finding: Laparotomic myomectomy was favored when the number (P = .000) and weight (P = .004) of fibroids were considered. Robotic surgery took a longer time than others (P = .00). When the impact of number of fibroids on achieving pregnancy was analyzed, both groups with lesser (P = .017) and greater (P < .001) than 6 fibroids preferred minimally invasive routes like laparoscopic or robotic surgery.

Study details: Findings are from a retrospective, cross-sectional study including 69 patients with infertility who underwent myomectomy approaches, of which 21, 24, and 24 patients underwent laparotomy, conventional laparoscopy, and robotic-assisted laparoscopy, respectively.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Morales HSG et al. JBRA Assist Reprod. 2021 Aug 20. doi: 10.5935/1518-0557.20210049.

Key clinical point: The surgical approach for removal of uterine fibroids should consider the number and size of fibroids, surgical time, and reproductive diagnosis with minimally invasive routes offered whenever possible because of its better outcome on achieving pregnancy.

Major finding: Laparotomic myomectomy was favored when the number (P = .000) and weight (P = .004) of fibroids were considered. Robotic surgery took a longer time than others (P = .00). When the impact of number of fibroids on achieving pregnancy was analyzed, both groups with lesser (P = .017) and greater (P < .001) than 6 fibroids preferred minimally invasive routes like laparoscopic or robotic surgery.

Study details: Findings are from a retrospective, cross-sectional study including 69 patients with infertility who underwent myomectomy approaches, of which 21, 24, and 24 patients underwent laparotomy, conventional laparoscopy, and robotic-assisted laparoscopy, respectively.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Morales HSG et al. JBRA Assist Reprod. 2021 Aug 20. doi: 10.5935/1518-0557.20210049.

Key clinical point: The surgical approach for removal of uterine fibroids should consider the number and size of fibroids, surgical time, and reproductive diagnosis with minimally invasive routes offered whenever possible because of its better outcome on achieving pregnancy.

Major finding: Laparotomic myomectomy was favored when the number (P = .000) and weight (P = .004) of fibroids were considered. Robotic surgery took a longer time than others (P = .00). When the impact of number of fibroids on achieving pregnancy was analyzed, both groups with lesser (P = .017) and greater (P < .001) than 6 fibroids preferred minimally invasive routes like laparoscopic or robotic surgery.

Study details: Findings are from a retrospective, cross-sectional study including 69 patients with infertility who underwent myomectomy approaches, of which 21, 24, and 24 patients underwent laparotomy, conventional laparoscopy, and robotic-assisted laparoscopy, respectively.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Morales HSG et al. JBRA Assist Reprod. 2021 Aug 20. doi: 10.5935/1518-0557.20210049.

Key clinical point: Uterine fibroids did not increase the risk for preterm births and were not associated with any clinical preterm birth subtype.

Major finding: Prevalence of fibroids was similar in pregnancies ending in preterm and term births (10.2% and 10.3%, respectively). Presence of fibroids was not associated with an overall risk for preterm birth (adjusted risk ratio [aRR], 0.88; 95% confidence interval [CI], 0.62-1.24) or preterm birth subtypes like medically indicated (aRR, 0.92; 95% CI, 0.43-1.96) or spontaneous (aRR, 1.27; 95% CI, 0.76-2.11) preterm births.

Study details: Findings are from a prospective cohort including 4,622 women with singleton pregnancies resulting in a live birth after 20 weeks of gestation.

Disclosures: This study was funded by National Institutes of Health, American Water Works Association Research Foundation, and the National Institute of General Medical Studies. The authors declared no conflict of interests.

Source: Sundermann AC et al. BMC Pregnancy Childbirth. 2021 Aug 17. doi: 10.1186/s12884-021-03968-2.

Key clinical point: Uterine fibroids did not increase the risk for preterm births and were not associated with any clinical preterm birth subtype.

Major finding: Prevalence of fibroids was similar in pregnancies ending in preterm and term births (10.2% and 10.3%, respectively). Presence of fibroids was not associated with an overall risk for preterm birth (adjusted risk ratio [aRR], 0.88; 95% confidence interval [CI], 0.62-1.24) or preterm birth subtypes like medically indicated (aRR, 0.92; 95% CI, 0.43-1.96) or spontaneous (aRR, 1.27; 95% CI, 0.76-2.11) preterm births.

Study details: Findings are from a prospective cohort including 4,622 women with singleton pregnancies resulting in a live birth after 20 weeks of gestation.

Disclosures: This study was funded by National Institutes of Health, American Water Works Association Research Foundation, and the National Institute of General Medical Studies. The authors declared no conflict of interests.

Source: Sundermann AC et al. BMC Pregnancy Childbirth. 2021 Aug 17. doi: 10.1186/s12884-021-03968-2.

Key clinical point: Uterine fibroids did not increase the risk for preterm births and were not associated with any clinical preterm birth subtype.

Major finding: Prevalence of fibroids was similar in pregnancies ending in preterm and term births (10.2% and 10.3%, respectively). Presence of fibroids was not associated with an overall risk for preterm birth (adjusted risk ratio [aRR], 0.88; 95% confidence interval [CI], 0.62-1.24) or preterm birth subtypes like medically indicated (aRR, 0.92; 95% CI, 0.43-1.96) or spontaneous (aRR, 1.27; 95% CI, 0.76-2.11) preterm births.

Study details: Findings are from a prospective cohort including 4,622 women with singleton pregnancies resulting in a live birth after 20 weeks of gestation.

Disclosures: This study was funded by National Institutes of Health, American Water Works Association Research Foundation, and the National Institute of General Medical Studies. The authors declared no conflict of interests.

Source: Sundermann AC et al. BMC Pregnancy Childbirth. 2021 Aug 17. doi: 10.1186/s12884-021-03968-2.

Key clinical point: The size of uterine leiomyoma commonly increases before 22-24 gestational weeks, with the growth being fastest before 11-14 weeks. The size remained almost unchanged from 22-24 weeks to the predelivery gestational weeks.

Major finding: The change in leiomyoma diameter from weeks 6-7 to 11-14, 11-14 to 22-24, 22-24 to 28-34, and 28-34 to predelivery gestational weeks was 0.767 cm, 0.367 cm, −0.133 cm, and −0.100 cm, respectively, with the difference between gestational intervals being statistically significant (P < .05). Overall, leiomyoma increased by 23.99% between weeks 6-7 to predelivery gestational weeks, with growth being highest between weeks 6-7 and 11-14 (9.92%).

Study details: Findings are from a prospective cross-sectional study including 394 pregnant women with uterine leiomyoma.

Disclosures: The study was funded by the Beijing Municipal Science & Technology Commission and Beijing Obstetrics and Gynecology Hospital. The authors declared no conflict of interests.

Source: Tian Y C et al. Int J Gynaecol Obstet. 2021 Aug 27. doi: 10.1002/ijgo.13903.

Key clinical point: The size of uterine leiomyoma commonly increases before 22-24 gestational weeks, with the growth being fastest before 11-14 weeks. The size remained almost unchanged from 22-24 weeks to the predelivery gestational weeks.

Major finding: The change in leiomyoma diameter from weeks 6-7 to 11-14, 11-14 to 22-24, 22-24 to 28-34, and 28-34 to predelivery gestational weeks was 0.767 cm, 0.367 cm, −0.133 cm, and −0.100 cm, respectively, with the difference between gestational intervals being statistically significant (P < .05). Overall, leiomyoma increased by 23.99% between weeks 6-7 to predelivery gestational weeks, with growth being highest between weeks 6-7 and 11-14 (9.92%).

Study details: Findings are from a prospective cross-sectional study including 394 pregnant women with uterine leiomyoma.

Disclosures: The study was funded by the Beijing Municipal Science & Technology Commission and Beijing Obstetrics and Gynecology Hospital. The authors declared no conflict of interests.

Source: Tian Y C et al. Int J Gynaecol Obstet. 2021 Aug 27. doi: 10.1002/ijgo.13903.

Key clinical point: The size of uterine leiomyoma commonly increases before 22-24 gestational weeks, with the growth being fastest before 11-14 weeks. The size remained almost unchanged from 22-24 weeks to the predelivery gestational weeks.

Major finding: The change in leiomyoma diameter from weeks 6-7 to 11-14, 11-14 to 22-24, 22-24 to 28-34, and 28-34 to predelivery gestational weeks was 0.767 cm, 0.367 cm, −0.133 cm, and −0.100 cm, respectively, with the difference between gestational intervals being statistically significant (P < .05). Overall, leiomyoma increased by 23.99% between weeks 6-7 to predelivery gestational weeks, with growth being highest between weeks 6-7 and 11-14 (9.92%).

Study details: Findings are from a prospective cross-sectional study including 394 pregnant women with uterine leiomyoma.

Disclosures: The study was funded by the Beijing Municipal Science & Technology Commission and Beijing Obstetrics and Gynecology Hospital. The authors declared no conflict of interests.

Source: Tian Y C et al. Int J Gynaecol Obstet. 2021 Aug 27. doi: 10.1002/ijgo.13903.

Key clinical point: Uterine fibroids (UFs) may grow continuously in some postmenopausal women, most likely because of the presence of small fibroids or obesity.

Major finding: The median growth rate of UFs was 12.9% every 6 months, with 79.5% of the UFs showing enlargement and 20.5% regressed spontaneously. The median growth rate of UFs was significantly higher in obese and overweight women than those with normal weight (P = .043). The growth was rapid in tumors with a diameter less than 3 cm vs greater than or equal to 5 cm (28.8% vs 9.1% in 6 months; P = .015).

Study details: Findings are from a retrospective longitudinal study including 102 postmenopausal women with 132 surgically identified UFs who had received at least 2 transvaginal ultrasound examinations in a 6-month interval.

Disclosures: This study was supported by the Capital Medical University Advanced Discipline Construction Project of Clinical Medicine. The authors declared no conflict of interests.

Source: Shen M et al. Menopause. 2021 Sep 6. doi: 10.1097/GME.0000000000001846.

Key clinical point: Uterine fibroids (UFs) may grow continuously in some postmenopausal women, most likely because of the presence of small fibroids or obesity.

Major finding: The median growth rate of UFs was 12.9% every 6 months, with 79.5% of the UFs showing enlargement and 20.5% regressed spontaneously. The median growth rate of UFs was significantly higher in obese and overweight women than those with normal weight (P = .043). The growth was rapid in tumors with a diameter less than 3 cm vs greater than or equal to 5 cm (28.8% vs 9.1% in 6 months; P = .015).

Study details: Findings are from a retrospective longitudinal study including 102 postmenopausal women with 132 surgically identified UFs who had received at least 2 transvaginal ultrasound examinations in a 6-month interval.

Disclosures: This study was supported by the Capital Medical University Advanced Discipline Construction Project of Clinical Medicine. The authors declared no conflict of interests.

Source: Shen M et al. Menopause. 2021 Sep 6. doi: 10.1097/GME.0000000000001846.

Key clinical point: Uterine fibroids (UFs) may grow continuously in some postmenopausal women, most likely because of the presence of small fibroids or obesity.

Major finding: The median growth rate of UFs was 12.9% every 6 months, with 79.5% of the UFs showing enlargement and 20.5% regressed spontaneously. The median growth rate of UFs was significantly higher in obese and overweight women than those with normal weight (P = .043). The growth was rapid in tumors with a diameter less than 3 cm vs greater than or equal to 5 cm (28.8% vs 9.1% in 6 months; P = .015).

Study details: Findings are from a retrospective longitudinal study including 102 postmenopausal women with 132 surgically identified UFs who had received at least 2 transvaginal ultrasound examinations in a 6-month interval.

Disclosures: This study was supported by the Capital Medical University Advanced Discipline Construction Project of Clinical Medicine. The authors declared no conflict of interests.

Source: Shen M et al. Menopause. 2021 Sep 6. doi: 10.1097/GME.0000000000001846.

Key clinical point: Women with uterine leiomyoma (UL) appeared to be at a higher risk of developing endometriosis. The risk increased further if UL was present along with comorbidities like infertility or endometritis.

Major finding: Patients with UL vs control participants were at a higher risk of developing endometriosis (adjusted hazard ratio [aHR], 6.44; P less than .001). The comorbidities significantly associated with risk for endometriosis were tube-ovarian infection (aHR, 2.86; P = .01), endometritis (aHR, 1.14; P < .001), infertility (aHR, 1.26; P <  .001), and allergic diseases (aHR, 1.11; P < .001).

Study details: Findings are from a large-scale nationwide cohort including 31,239 women with UL matched with 1,24,956 control participants and followed up for 14 years.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Lin KY et al. PLoS One. 2021 Aug 26. doi: 10.1371/journal.pone.0256772.

Key clinical point: Women with uterine leiomyoma (UL) appeared to be at a higher risk of developing endometriosis. The risk increased further if UL was present along with comorbidities like infertility or endometritis.

Major finding: Patients with UL vs control participants were at a higher risk of developing endometriosis (adjusted hazard ratio [aHR], 6.44; P less than .001). The comorbidities significantly associated with risk for endometriosis were tube-ovarian infection (aHR, 2.86; P = .01), endometritis (aHR, 1.14; P < .001), infertility (aHR, 1.26; P <  .001), and allergic diseases (aHR, 1.11; P < .001).

Study details: Findings are from a large-scale nationwide cohort including 31,239 women with UL matched with 1,24,956 control participants and followed up for 14 years.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Lin KY et al. PLoS One. 2021 Aug 26. doi: 10.1371/journal.pone.0256772.

Key clinical point: Women with uterine leiomyoma (UL) appeared to be at a higher risk of developing endometriosis. The risk increased further if UL was present along with comorbidities like infertility or endometritis.

Major finding: Patients with UL vs control participants were at a higher risk of developing endometriosis (adjusted hazard ratio [aHR], 6.44; P less than .001). The comorbidities significantly associated with risk for endometriosis were tube-ovarian infection (aHR, 2.86; P = .01), endometritis (aHR, 1.14; P < .001), infertility (aHR, 1.26; P <  .001), and allergic diseases (aHR, 1.11; P < .001).

Study details: Findings are from a large-scale nationwide cohort including 31,239 women with UL matched with 1,24,956 control participants and followed up for 14 years.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Lin KY et al. PLoS One. 2021 Aug 26. doi: 10.1371/journal.pone.0256772.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Key clinical point: Among Black women, ambient concentrations of ozone (O₃), but not particulate matter <2.5 microns (PM_2.5) or nitrogen dioxide (NO₂), were associated with an increased risk for uterine fibroids.

Major finding: Ambient O₃ concentrations were significantly associated with an increased risk for uterine fibroids (hazard ratio for a 1-interquartile range increase, 1.19; 95% confidence interval, 1.07-1.32), particularly in women aged <35 years and parous women. However, concentrations of PM_2.5 and NO₂ had no significant associations with uterine fibroids risk.

Study details: The data come from a prospective cohort study of 21,998 premenopausal Black women in the US.

Disclosures: This study was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences. LA Wise reported relationships with AbbVie, Inc., Swiss Precision Diagnostics, Sandstone Diagnostics, FertilityFriend.com, and Kindara.com. M Jerrett reported receiving consultancy fees from the Health Effects Institute. The remaining authors declared no conflict of interests.

Source: Wesselink AK et al. Hum Reprod. 2021 May 13. doi: 10.1093/humrep/deab095.

Key clinical point: Among Black women, ambient concentrations of ozone (O₃), but not particulate matter <2.5 microns (PM_2.5) or nitrogen dioxide (NO₂), were associated with an increased risk for uterine fibroids.

Major finding: Ambient O₃ concentrations were significantly associated with an increased risk for uterine fibroids (hazard ratio for a 1-interquartile range increase, 1.19; 95% confidence interval, 1.07-1.32), particularly in women aged <35 years and parous women. However, concentrations of PM_2.5 and NO₂ had no significant associations with uterine fibroids risk.

Study details: The data come from a prospective cohort study of 21,998 premenopausal Black women in the US.

Disclosures: This study was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences. LA Wise reported relationships with AbbVie, Inc., Swiss Precision Diagnostics, Sandstone Diagnostics, FertilityFriend.com, and Kindara.com. M Jerrett reported receiving consultancy fees from the Health Effects Institute. The remaining authors declared no conflict of interests.

Source: Wesselink AK et al. Hum Reprod. 2021 May 13. doi: 10.1093/humrep/deab095.

Key clinical point: Among Black women, ambient concentrations of ozone (O₃), but not particulate matter <2.5 microns (PM_2.5) or nitrogen dioxide (NO₂), were associated with an increased risk for uterine fibroids.

Major finding: Ambient O₃ concentrations were significantly associated with an increased risk for uterine fibroids (hazard ratio for a 1-interquartile range increase, 1.19; 95% confidence interval, 1.07-1.32), particularly in women aged <35 years and parous women. However, concentrations of PM_2.5 and NO₂ had no significant associations with uterine fibroids risk.

Study details: The data come from a prospective cohort study of 21,998 premenopausal Black women in the US.

Disclosures: This study was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences. LA Wise reported relationships with AbbVie, Inc., Swiss Precision Diagnostics, Sandstone Diagnostics, FertilityFriend.com, and Kindara.com. M Jerrett reported receiving consultancy fees from the Health Effects Institute. The remaining authors declared no conflict of interests.

Source: Wesselink AK et al. Hum Reprod. 2021 May 13. doi: 10.1093/humrep/deab095.

Key clinical point: Single-port access (SPA) myomectomy in combination with uterine artery ligation (UAL) enables removal of large uterine fibroids while reducing blood loss.

Major finding: The median weight of total resected uterine fibroids was higher for the patients who received UAL vs those who did not (210 g vs 119 g; P = .023). There were no significant differences between the groups in terms of total surgery time, estimated blood loss, perioperative hemoglobin changes, postoperative analgesic use, and postoperative complications.

Study details: Surgical outcomes of 24 patients who underwent SPA myomectomy with UAL and 32 patients who underwent SPA myomectomy only were retrospectively reviewed.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Noh JJ et al. Taiwan J Obstet Gynecol. 2021 Jul 8. doi: 10.1016/j.tjog.2021.05.029.

Key clinical point: Single-port access (SPA) myomectomy in combination with uterine artery ligation (UAL) enables removal of large uterine fibroids while reducing blood loss.

Major finding: The median weight of total resected uterine fibroids was higher for the patients who received UAL vs those who did not (210 g vs 119 g; P = .023). There were no significant differences between the groups in terms of total surgery time, estimated blood loss, perioperative hemoglobin changes, postoperative analgesic use, and postoperative complications.

Study details: Surgical outcomes of 24 patients who underwent SPA myomectomy with UAL and 32 patients who underwent SPA myomectomy only were retrospectively reviewed.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Noh JJ et al. Taiwan J Obstet Gynecol. 2021 Jul 8. doi: 10.1016/j.tjog.2021.05.029.

Key clinical point: Single-port access (SPA) myomectomy in combination with uterine artery ligation (UAL) enables removal of large uterine fibroids while reducing blood loss.

Major finding: The median weight of total resected uterine fibroids was higher for the patients who received UAL vs those who did not (210 g vs 119 g; P = .023). There were no significant differences between the groups in terms of total surgery time, estimated blood loss, perioperative hemoglobin changes, postoperative analgesic use, and postoperative complications.

Study details: Surgical outcomes of 24 patients who underwent SPA myomectomy with UAL and 32 patients who underwent SPA myomectomy only were retrospectively reviewed.

Disclosures: No information on funding was available. The authors declared no conflict of interests.

Source: Noh JJ et al. Taiwan J Obstet Gynecol. 2021 Jul 8. doi: 10.1016/j.tjog.2021.05.029.