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Introduction Uterine fibroids (UFs) are benign tumors which are derived from the smooth muscle cells of the uterus. Recent studies have demonstrated that the development of UFs can be particularly related to vitamin D and its receptor. Vitamin D comprises a group of fat-soluble steroid compounds which exert powerful, pleiotropic effects all over the human body. These actions are mediated by a specific type of receptor – vitamin D receptor (VDR). Recent findings have focused on the possible role of VDR genetic variations in the development of several types of diseases, e.g. autoimmune system diseases, various cancers and infections. Material and methods The aim of the study was to evaluate the association between rs731236, rs1544410, and rs2228570 polymorphisms in the VDR (vitamin D receptor) gene and the incidence of UFs in Caucasian women. A total of 197 patients (114 fibroid-positive and 83 controls) were included in this retrospective cohort study. VDR gene polymorphisms rs731236 (TaqI), rs1544410 (BsmI) and rs2228570 (FokI) were determined using TaqMan and Simple Probes. Results No statistically significant differences in the occurrence of selected VDR polymorphisms were observed between UF-positive women and healthy controls. Conclusions We found no association between rs731236, rs1544410, and rs2228570 VDR polymorphisms and UF incidence in Caucasian women. Larger sample size and multi-ethnic studies are necessary to investigate the matter further.

Uterine fibroids (UFs) are the most common benign tumors of female genital diseases, unlike uterine leiomyosarcoma (LMS), a rare and aggressive uterine cancer. This narrative review aims to discuss the biology and diagnosis of LMS and, at the same time, their differential diagnosis, in order to distinguish the biological and molecular origins. The authors performed a Medline and PubMed search for the years 1990–2022 using a combination of keywords on the topics to highlight the many genes and proteins involved in the pathogenesis of LMS. The mutation of these genes, in addition to the altered expression and functions of their enzymes, are potentially biomarkers of uterine LMS. Thus, the use of this molecular and protein information could favor differential diagnosis and personalized therapy based on the molecular characteristics of LMS tissue, leading to timely diagnoses and potential better outcomes for patients.

Background: The purpose of this article was to evaluate the effect of paracervical block before ultrasound-guided high-intensity-focused ultrasound treatment of adenomyosis and uterine fibroids. Methods: This retrospective analysis examined 2173 women who received HIFU treatment for uterine fibroids and adenomyosis, among them 311 patients with paracervical block and 1862 patients without paracervical block, from February 4, 2010 to March 8, 2019. We assessed treatment time, ablation time, treatment energy and volume reduction. Paracervical block (10 cc of 2% lidocaine diluted with epinephrine 1:1 million) was performed before treatment. Results: When paracervical block was performed, the total treatment time was estimated to be 0.886 times (expected (–0.121)) which was statistically significantly shorter (p < 0.0001), ablation time was statistically significantly shorter by 0.853 times (expected (–0.159)) (p < 0.0001), and the total energy was statistically significantly smaller by 0.891 times (expected (–0.115)) (p = 0.0003). There was no significant difference in volume change between the group with and without paracervical block. However, total treatment time, ablation time, and treatment energy were all statistically significantly lower in the group treated with paracervical block. Conclusions: Paracervical block before USgHIFU treatment was a cost-effective method because it helped reduce the total treatment time, ablation time, and total energy.

Abstract Objectives Uterine fibroids are common among the black race and associated with adverse outcomes in pregnancy. The aim of this study was to determine the prevalence, clinical presentation and maternal and foetal outcomes of birth among pregnant women with leiomyoma in two secondary care hospitals in Limbe and Buea, Cameroon. Results The prevalence of fibroid in pregnancy was 16.7%. Respondents with leiomyoma were older than those without (p

Women with congenital amino acid disorders, including maple syrup urine disease (MSUD), are at risk of metabolic crisis at delivery. There are still only a few case reports of maternal MSUD globally, and we are the first to report the successful perinatal management of a woman with classical MSUD in Japan. A healthy baby was delivered by scheduled cesarean section despite the presence of several uterine fibroids. With precise diet therapy and accurate preparation, she completed the postpartum period without metabolic decompensation. Although her clinical outcome was favorable, she experienced hypoproteinemia at delivery because the available branched-chain amino acid-free medical food did not contain sufficient protein to meet the recommended nutrient intake. Therefore, this case also indicates a potential issue regarding a shortage of variations in specific amino acid-free medical food in Japan, which should be addressed to achieve a better nutrient status of adults with MSUD and other amino acid disorders.

Background: Foramen of Winslow hernia (FWH) is a rare but emergent condition caused by an increase in the foramen diameter, visceral mobility, and intra-abdominal pressure. To the best of our knowledge, this is the first study to report a case of FWH secondary to large uterine fibroids that was successfully treated with laparoscopic surgery. Case presentation: A 52-year-old woman with large uterine fibroids was diagnosed with FWH. Because of the absence of signs of bowel ischemia and peritonitis, we performed an elective laparoscopic surgery through a 5-port system after bowel decompression using a long intestinal tube. Although foramen of Winslow closure was not performed, her postoperative course was uneventful. Conclusions: Laparoscopic surgery for FWH is considered an extremely effective surgical treatment option because of its safety and efficacy in performing delicate procedures (such as adhesiolysis) with a good magnified field of view. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to compare the safety of local injection of 6 units of pituitrin diluted to 20 mL vs 6 units of pituitrin diluted to 10 mL for laparoscopic uterine fibroid (UF) surgery. Methods: This was a randomized clinical trial of patients scheduled for laparoscopic UF surgery at Fu Xing Hospital, Capital Medical University, Beijing, China. Ninety-six patients were divided into two groups according to the concentration of pituitrin utilized: Group1 (6 units of pituitrin diluted to 20 mL for all injection) 48 cases; Group2 (6 units of pituitrin diluted to 10 mL for all injection) 48 cases. The observation indicators were mean arterial pressure (MAP1) and heart rate (HR1) upon entering the operating room; the lowest mean arterial pressure (MAP2) and the highest heart rate (HR2) within 5 minutes after injecting pituitrin; the highest mean arterial pressure (MAP3) and the lowest heart rate (HR3) within 30 minutes after injecting pituitrin; hemoglobin (Hb1) and hematocrit (Hct1) within one week before surgery; hemoglobin (Hb2) and hematocrit (Hct2) within one day after surgery; and the time for the mean arterial pressure to return to the level of entering the operation room after using pituitrin (Recovery Time). Results: All baseline and observation data showed no statistical difference between the two groups. Conclusions: The safety profile of local injection of pituitrin in the 6 units of pituitrin diluted to 20 mL and 6 units of pituitrin diluted to 10 mL are the same when used for laparoscopic UF surgery.

Background and Objectives. Uterine fibroids are relatively common in reproductive-age women and are directly linked to pregnancy. There are many debates about performing a myomectomy at the same time as a caesarian section (CS) in such cases due to the risk of a hemorrhage. Our study aims to investigate fibroid features and their evolution in pregnancy, complications of a myomectomy during CS and maternal and fetal obstetric outcomes of pregnancies with fibroids. Materials and methods. We realize a prospective study that includes 57 patients with fibroids in pregnancy diagnosed in January 2017–June 2019. We analyze the number, the location and the growth of fibroids during pregnancy and the maternal and fetal outcome. We appreciate the bleeding in patients with a myomectomy and without a myomectomy during CS, using hemoglobin values before and after birth. Results. Most of the patients present single fibroids that are 30–160 mm in size, located on the anterior uterine wall. Vaginal delivery is used in 7% of women, whereas 85.96% deliver by CS. In addition, 68% of fibroids are diagnosed in the first trimester. In most cases, the fibroid has maximum growth in the second trimester of pregnancy. The myomectomy rate for fibroids during CS is 24.48. Hemoglobin values showed no statistically significant difference between the two groups with and without myomectomy. The operating time is double for the group with a myomectomy associated with a CS. The results of the obstetric outcomes are abortion in 7% of all patients, whereas premature delivery and births at term are 9.43% and 90.57%, respectively. Conclusions. The decision of performing a myomectomy during pregnancy can be a challenge and must be performed for selected cases. This procedure may have several benefits, such as avoiding another operation to remove fibroids.

To assess a correlation between the shrinkage of the fibroid and the course of the symptoms. Fourteen patients with symptomatic uterine leiomyomas (mean fibroid volume: 111.45 cm3) underwent percutaneous microwave ablation. Contrast-enhanced MRI follow-up was performed before and after treatment to evaluate the volume shrinkage. Two scores obtained from the Uterine Fibroids Symptom and Quality of Life questionnaire were used to perform a clinical follow-up to evaluate the symptoms and the quality of life at baseline, and at 3, 6 and 12 months after treatment. All patients were treated, no complications occurred. During a mean MR follow-up of 8.1 months we observed shrinkage of the fibroids in all patients (mean 70.3 cm3). During 12 months clinical follow-up, we observed a significant improvement of symptoms and an excellent improvement of quality of life (p <.001). Uterine fibroids percutaneous microwave ablation is a safe tool to obtain a significant improvement in quality of life for all the patients of our cohort. [ABSTRACT FROM AUTHOR]

Background: Although uterine fibroids are a common gynecologic neoplasm, uterine diverticulum accompanied by a uterine fibroid is unique. In addition, pregnancy complicated with uterine diverticulum is extremely rare. We experienced a case of a uterine fibroid that was associated with a uterine diverticulum that enlarged during pregnancy and puerperium.Case Presentation: A 25-year-old nulligravida woman had an abnormal uterine cavity surrounded by myomatous mass. After natural conception, the mass and pouch had enlarged during pregnancy. Six months after elective cesarean delivery, she underwent laparotomy because of abdominal pain caused by the myomatous mass and the fluid inside. The tumor was connected to the midline of the posterior wall of the normal uterus. The resected tumor was pathologically diagnosed as leiomyoma and diverticulum.Conclusions: Pregnancy can stimulate uterine fibroids to form uterine diverticula. Resection of the diverticulum and fibroid is a useful option for symptomatic patients with desired future fertility. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Ketogenic diet (KGD) is a low-carbohydrate, high-fat and average protein dietary formulation, which has been reported with the ability to ameliorate several metabolic diseases, especially those under the direct influence of hormonal disruptions. Monosodium glutamate (MSG) had been found to induce uterine fibroids in laboratory animals through alterations to hormones, lipids and oxidative state. The present study was conducted to evaluate the effect of KGD on MSG-induced uterine fibroid. METHODS: In this experimental study twenty-four female Wistar rats were divided into four groups of six. Control group received distilled water while the remaining groups were given 300 mg/kg body weight of MSG once a day for 28 days. Thereafter, the three groups of MSG, MSG + keto group 1 and MSG + keto group 2 received standard rat chow, cabbage-based ketogenic diet and coconut-based ketogenic diet, respectively for 42 days. Estrogen, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), malondialdehyde (MDA), Superoxide Dismutase (SOD), catalase (CAT), and Total Cholesterol (TC) were determined in the blood of animals using standard methods and induction of fibroids was confirmed in the uterus by histomorphological measurements. FINDINGS: Significant elevations (p<0.05) were observed in the levels of estrogen (1.80±0.09 &1.27±0.12), LH (1.04±0.04 & 0.39±0.01), FSH (1.51±0.04 & 0.65±0.03), TC and MDA in the MSG group compared to control. There were significant decreases (p<0.05) in the activities of CAT and SOD enzymes in the MSG group compared to control. Histological analysis confirmed significant reduction (p<0.05) in leiomyomas of the dietary treatment groups compared to that of MSG. CONCLUSION: The study suggests that cabbage- and coconut-based KGD may control the occurrence and progression of fibroids through reduction of oxidative damage and amelioration of hormonal imbalance induced by MSG. [ABSTRACT FROM AUTHOR]

Non-surgical treatment options for uterine fibroids are uterine artery embolization (UAE), high-intensity focused ultrasound ablation (HIFUA), and percutaneous microwave ablation (PMWA). Magnetic resonance imaging (MRI) is the reference standard imaging method before and after these procedures. Contrast-enhanced ultrasound (CEUS) has been studied as an alternative to MRI for evaluating the fibroids' characteristics and responses to non-surgical treatments. PubMed, Ovid MEDLINE and Scopus databases were searched for literature published from January 2000 through June 7, 2020, that investigated the application of CEUS as an adjunct to monitor UAE, HIFUA or PMWA in human uterine fibroid treatments. Two independent reviewers analyzed 128 publications, out of which 17 were included. Based on this systematic review, CEUS provides detailed data about fibroid volume and vascularization prior, during and post UAE, and it helps determine the endpoint of the procedure. HIFUA with intra-procedural CEUS has faster volume shrinkage over a shorter time period with less needed energy and provides early detection of residual tissue after HIFUA. CEUS and contrast-enhanced MRI have sufficient agreement to be used interchangeably in the clinic to evaluate the therapeutic effect of PMWA and HIFUA on fibroids. [ABSTRACT FROM AUTHOR]

High-intensity focused ultrasound (HIFU) is a promising and non-invasive therapy for symptomatic uterine fibroids. Currently, the main image-guided methods for HIFU include magnetic resonance-guided (MR-HIFU) and ultrasound-guided (US-HIFU). However, there are few comparative studies on the therapeutic efficacy and safety of MR-HIFU and US-HIFU in treating symptomatic uterine fibroids with a volume <300 cm3. We performed this meta-analysis to evaluate the efficacy and safety of MR-HIFU and US-HIFU in treating symptomatic uterine fibroids with a volume <300 cm3. We searched relevant literature in PubMed, EMBASE, Cochrane Library CNKI from inception until 2021. The mean value, the proportion, and their 95% confidence intervals (CIs) were measured by random-effects models. Publication bias was assessed using funnel plots. 48 studies met our inclusion criteria—28 describing MR-HIFU and 20 describing US-HIFU. The mean non-perfused volume rate (NPVR) was 81.07% in the US-HIFU group and 58.92% in the MR-HIFU group, respectively. The mean volume reduction rates at month-3, month-6, and month-12 were 42.42, 58.72, and 65.55% in the US-HIFU group, while 34.79, 37.39, and 36.44% in the MR-HIFU group. The incidence of post-operative abdominal pain and abnormal vaginal discharge in the US-HIFU group was lower than that of MRI-HIFU. However, post-operative skin burn and sciatic nerve pain were more common in the US-HIFU group compared with MRI-HIFU. The one-year reintervention rate after MR-HIFU was 13.4%, which was higher than 5.2% in the US-HIFU group. US-HIFU may show better efficiency and safety than MR-HIFU in treating symptomatic fibroids with a volume <300 cm3. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the feasibility of T2 relaxation time in predicting the immediate technical outcome i.e., nonperfused volume ratio (NPVr) of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) treatment of symptomatic uterine fibroids and to compare it with existing T2-weighted imaging methods (Funaki classification and scaled signal intensity, SSI). Materials and methods: 30 patients with 32 uterine fibroids underwent an MRI study including a quantitative T2 relaxation time measurement prior to MRgHIFU treatment. T2 relaxation times were measured with a multi-echo fast imaging-based technique with 16 echoes. The correlation between pretreatment values of the uterine fibroids and treatment outcomes, that is nonperfused volume ratios (NPVr), was assessed with nonparametric statistical measures. T2 relaxation time-based method was compared to existing T2-weighted imaging-based methods using receiver-operating-characteristics (ROC) curve analysis and Chi-square test. Results: Nonparametric measures of association revealed a statistically significant negative correlation between T2 relaxation time values and NPVr. The T2 relaxation time classification (T2 I, T2 II, and T2 III) resulted in the whole model p-value of 0.0019, whereas the Funaki classification resulted in a p-value of 0.56. The T2 relaxation time classification (T2 I and T2 II) achieved a whole model of a p-value of 0.0024, whereas the SSI classification had a p-value of 0.0749. Conclusions: A longer T2 relaxation time of the fibroid prior to treatment correlated with a lower NPVr. Based on our results, the T2 relaxation time classifications seem to outperform the Funaki classification and the SSI method. [ABSTRACT FROM AUTHOR]

Uterine leiomyomas (ULs) are common benign tumors seen in a large percent of women that can be classified based on their location within the uterus. They can cause a number of pelvic complications and can be managed medically, but more often surgically. Uterine pyomyomas often occur postpartum, possibly from infarction, and can lead to degeneration and sepsis. Our patient presents with a two-month development of a potential pyomyoma, found initially on computed tomography (CT). Office exam reveals a protruding mass from the cervical os, and removal was attempted but ultimately postponed for general anesthesia exam due to pain. The leiomyoma was removed and shown to be necrosing. Pyomyomas are often insidious and can often mimic other concerning pathologies. Modern imaging can show lesions within the pelvis but struggle to determine between fluid collection and possible infarcted masses. The importance of quality care measures in cases like this deserve to be emphasized to prevent serious complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Wynn et al.)

Uterine fibroid is considered as the most common pelvic tumor in women during their reproductive years. Symptomatic uterine fibroids can cause abnormal uterine bleeding, anemia, pressure symptoms and fertility issues and also have a significant influence on patient’s quality of life. These are the most common indications for hysterectomy worldwide. We report a 43-year-old woman with abnormal vaginal bleeding and dysmenorrhea due to large size of uterine leiomyoma which was candidate for myomectomy. Due to her virginity she couldn’t undergo uterine surgery. She preferred to use non-surgical treatments and presented to our traditional Persian medicine outpatient clinic. In order to control menorrhagia and dysmenorrhea, dry cupping therapy was recommended to her for three times a week. After a period of two months, dysmenorrhea and vaginal bleeding were decreased noticeably. In addition, a significant reduction in tumor size was observed. This case shows dry cupping therapy can be effective and safe in decreasing fibroid-related symptoms like dysmenorrhea and excess bleeding and also the size of fibroid. It seems that this method can be integrated with current therapeutic approaches. However, further clinical studies need to establish the efficacy and safety of dry cupping therapy for the management of uterine fibroids.

Abstract Case A 40 year old woman with a history of a myomectomy visited the Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan, following 2 years of infertility. Magnetic resonance imaging detected an abnormal endometrial‐like pseudo‐cavity. A hysterosalpingography also revealed an abnormal accumulation of contrast medium at the myometrial scar site. A transvaginal ultrasound showed a thin myometrium at the lower uterine body. The patient conceived via in vitro fertilization under a luteal phase down‐regulation protocol (long protocol) for controlled ovarian stimulation, followed by a cryopreserved embryo transfer during her natural ovulation cycle. After the embryo transfer, the gestational sac was located at the subserosal site of the myomectomy scar. Outcome An emergent laparoscopic operation was performed and the embryo was removed successfully via laparoscopy under transvaginal ultrasonography. Conclusion A subserosal uterine pregnancy is a rare form of intramural pregnancy, which is a rare subtype of an ectopic pregnancy, which could occur at the myomectomy site, especially after an embryo transfer. It is believed that this rare ectopic pregnancy resulted from embryo implantation under the serosa through a micro‐sinus tract that was a site of suture failure of the myomectomy scar and was partially affected by the embryo transfer. Clinicians should consider the possibility of an ectopic pregnancy after uterine surgery, including a myomectomy.

Low vitamin D concentrations were presented in a significant proportion of the population. Many diseases in people, both middle and old, were directly associated with vitamin D deficiency. The effect of vitamin D levels on reproductive function in both men and women has been proven. Low vitamin D concentrations have been associated with a wide range of adverse maternal and offspring health outcomes in observational epidemiological studies. Complications of pregnancy with a low level of vitamin D are pre-eclampsia, gestational diabetes and premature birth. It is proved that the appointment of vitamin D to women during pregnancy reduces the proportion of cesarean section in delivery. Numerous authors prove the role of vitamin D in the pathogenetic chain of the polycystic ovary syndrome. It was found that during the menopause due to the violation of steroidogenesis there is a loss of bone mass due to vitamin D deficiency. In addition, a decrease in the level of vitamin D is associated with the occurrence of uterine fibroids. However, despite a dearth of interventional evidence supporting supplementation/treatment of vitamin D in randomised controlled trial settings, it is generally accepted that supplementation/treatment is not harmful and may have some significant short- and long-term health benefits. In this regard, timely correction of vitamin D deficiency becomes very important in solving reproductive problems. This review focuses on the problem of correcting the level of vitamin D in different population groups. Treatment of vitamin D deficient women and vitamin D supplementation is safe and is recommended for all women who are pregnant or breastfeeding.

Objectives: Uterine fibroids are capable of causing infertility, but there are no definite criteria for which laparoscopic uterine myomectomy (LM) is known to be beneficial. To investigate the usefulness of LM, we examined pregnancy rates in patients with infertility with no obvious cause except for the presence of uterine fibroids. Materials and Methods: We retrospectively reviewed the clinical records at Suzuki Memorial Hospital between June 2010 and August 2014. We found 60 eligible patients (LM group, 46; non-LM group, 14). The criteria for performing LM were a maximal fibroid diameter of 40 mm or more or the presence of >4 fibroids. Results: The duration of infertility before the first visit was significantly longer in the LM group; although there was no significant difference in the mean patient age and body mass index. Pregnancy was achieved in 45.7% of patients (21/46) in the LM group and 28.6% (4/14) in the non-LM group. There were no pregnancies in patients with >10 fibroids. The postoperative pregnancy rate in the LM group was comparable to previously reported pregnancy rates. Conclusions: Our criteria for performing LM in patients with no obvious cause for infertility except for uterine fibroids seem appropriate, especially when the fibroids are large and the number of fibroids is between 4 and 9. However, our results suggest that the effectiveness of LM is low in patients with 10 or more uterine fibroids.

Objective: This article reports on 3-year clinical outcomes of the Sonography Guided Transcervical Ablation of Uterine Fibroids (SONATA) pivotal trial of transcervical fibroid ablation (TFA) in women with symptomatic uterine myomata. Materials and Methods: The SONATA, prospective, controlled, multicenter interventional trial enrolled 147 premenopausal women with symptomatic uterine fibroids who underwent uterus-preserving, sonography-guided TFA with the Sonata® System (Gynesonics, Inc., Redwood City, CA, USA). Clinical outcomes were assessed over 3 years and included surgical reinterventions, Symptom Severity Score (SSS), and Health-Related Quality of Life (HRQoL) subscales of the Uterine Fibroid Symptom and Quality-of-Life Questionnaire, EuroQol 5-Dimension (EQ-5D) questionnaire, Overall Treatment Effect, treatment satisfaction, physical activity, work impairment, pregnancy outcomes, and adverse events. Results: The 3-year rates of surgical reintervention for heavy menstrual bleeding calculated by the binomial and Kaplan–Meier methods were 9.2% and 8.2%, respectively. Compared to baseline, mean SSS decreased from 55 ± 19 to 22 ± 21, HRQoL increased from 40 ± 21 to 83 ± 23, and EQ-5D increased from 0.72 ± 0.21 to 0.88 ± 0.16 (all p < 0.001). Treatment benefit on the SSS, HRQoL, and EQ-5Q exceeded the minimal clinically important difference at every follow-up visit over 3 years. At 3 years, 94% of the subjects reported treatment satisfaction, 88% reported reduced fibroid symptoms, work absenteeism due to fibroid symptoms decreased from 2.9% to 1.4%, and impairment due to fibroids decreased from 51% to 12% for work, and 58% to 14% for physical activity (all p < 0.001). No late complications occurred. Conclusions: Women treated with sonography-guided TFA in the SONATA pivotal trial experienced significant and durable reduction of fibroid-related symptoms, with low surgical reintervention rates over 3 years of follow-up. [ABSTRACT FROM AUTHOR]

Objective: To prospectively evaluate the association between dietary fat intake and risk of uterine fibroids; and to evaluate the association between erythrocyte membrane fatty acid (FA) levels and fibroid risk.Design: Prospective cohort study. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence interval (CI). In a subset of participants 34 individual FAs were measured and logistic regression analysis was used to estimate odds ratios (ORs) and 95% CI for the association between FA tertiles and fibroids.Setting: Not applicable.Patient(s): Premenopausal US women (81,590) in the Nurses' Health Study II, aged 25-42 years at enrollment in 1989 for whom diet was assessed by a food frequency questionnaire. A total of 553 participants with erythrocyte FA measurements.Intervention(s): Not applicable.Main Outcome Measure(s): Cases of fibroids were defined on the basis of self-reported ultrasound or hysterectomy confirmation.Result(s): A total of 8,142 cases of ultrasound-confirmed or hysterectomy-confirmed were diagnosed during an 18-year period (1991-2009). No associations were observed between intake of any dietary fats and fibroids in the multivariable models. However, when erythrocyte FAs were examined, an inverse association was observed between total n-3 polyunsaturated FAs and likelihood of fibroids (OR for third versus first tertile, 0.41; 95% CI 0.19-0.89). In addition, total trans FAs were associated with more odds of fibroids (OR for third tertile, 3.33; 95% CI 1.50-7.38).Conclusion(s): Our findings provide preliminary suggestions that n-3 polyunsaturated FAs and trans FAs may play a role in fibroid etiology; however, these results should be confirmed in future studies. [ABSTRACT FROM AUTHOR]

Selective progesterone receptor modulators (SPRMs) are a new class of compounds developed to target the progesterone receptor (PR) with a mix of agonist and antagonist properties. These compounds have been introduced for the treatment of several gynecological conditions based on the critical role of progesterone in reproduction and reproductive tissues. In patients with uterine fibroids, mifepristone and ulipristal acetate have consistently demonstrated efficacy, and vilaprisan is currently under investigation, while studies of asoprisnil and telapristone were halted for safety concerns. Mifepristone demonstrated utility for the management of endometriosis, while data are limited regarding the efficacy of asoprisnil, ulipristal acetate, telapristone, and vilaprisan for this condition. Currently, none of the SPRMs have shown therapeutic success in treating endometrial cancer. Multiple SPRMs have been assessed for efficacy in treating PR-positive recurrent breast cancer, with in vivo studies suggesting a benefit of mifepristone, and multiple in vitro models suggesting the efficacy of ulipristal acetate and telapristone. Mifepristone, ulipristal acetate, vilaprisan, and asoprisnil effectively treated heavy menstrual bleeding (HBM) in patients with uterine fibroids, but limited data exist regarding the efficacy of SPRMs for HMB outside this context. A notable class effect of SPRMs are benign, PR modulator-associated endometrial changes (PAECs) due to the actions of the compounds on the endometrium. Both mifepristone and ulipristal acetate are effective for emergency contraception, and mifepristone was approved by the US Food and Drug Administration (FDA) in 2012 for the treatment of Cushing's syndrome due to its additional antiglucocorticoid effect. Based on current evidence, SPRMs show considerable promise for treatment of several gynecologic conditions. [ABSTRACT FROM AUTHOR]

Background: There is a growing body of evidence on low serum vitamin-D levels and the risk of uterine leiomyomas (UL). Therefore, this systematic review and meta-analysis was conducted to investigate the association between serum vitamin D levels and UL occurrence. Methods: Searches were systematically conducted of the electronic databases PubMed, Scopus, EMBASE, Web of Science (ISI), Cochrane library, Ovid, and Google Scholar to identify relevant studies from inception until February 6, 2020. Heterogeneity across the included studies was examined using Cochran's Q and I-square (I²). Data was pooled using random effects modeling and expressed as standardized mean differences (SMDs). Results: Nine eligible studies with a total of 1730 participants (835 patients with UL and 895 controls) were included in the current meta-analysis. Pooled results with random effects modeling indicated that serum vitamin D levels were significantly lower in patients with UL than in the control group (n =9, SMD=- 0.67; 95% CI, - 0.98, - 0.35, p < 0.001; I² = 89.3%, p < 0.001). Based on the findings of subgroup analyses, it was found that the SMD values across the included studies from Asia (n =4, SMD=- 1.20; 95% CI, - 1.45, - 0.96, p < 0.001; I² = 30.6%, p = 0.229) were lower than those from Europe (n =3, SMD=- 0.34; 95% CI, - 0.49, - 0.18, p < 0.001; I² =0.0%, p = 0.602) and Africa (n =2, SMD=- 0.13; 95% CI, - 0.29, 0.04, p = 0.128; I² =0.0%, p = 0.417), although the difference was not significant in Africa. Publication year was also found to be a potential contributor's variable in the pooled SMD using the meta-regression method (t = - 3.00, p = 0.02). Conclusions: To the best of our knowledge, the current meta-analysis showed for the first time that serum vitamin D levels were significantly lower in women with UL in selected populations. [ABSTRACT FROM AUTHOR]

Background: In magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) treatment of uterine fibroids, the immediate ablation response is significantly affected by blood perfusion. The variability of measurement for blood perfusion is critical due to the inherent non-uniformity of tumor perfusion and its dependence on reproducible region of interest (ROI) placement.Purpose: To investigate the value of whole-tumor ROI (ROIwt) analysis for quantitative perfusion in predicting immediate ablation response of uterine fibroids in MR-HIFU.Material and Methods: Thirty-one fibroids in 28 eligible patients were treated with MR-HIFU. Quantitative perfusion parameters (Ktrans, Kep, and Vp) derived from dynamic contrast-enhanced MRI were obtained before MR-HIFU treatment. The ROIwt and single-layer ROI (ROIsl) were used for quantitative perfusion analysis. T1 contrast-enhanced MRI immediately after MR-HIFU treatment was conducted to determine the non-perfused volume ratio (NPVR). Intraclass correlation coefficient (ICC) was used for consistency test. Spearman's correlation and multivariate linear regression were used to investigate the predictors of the NPVR. Received operating characteristic (ROC) curve was used to test the predictive efficacy of quantitative perfusion parameter.Results: The intra- and inter-observer ICC of the quantitative perfusion parameters from ROIwt were higher than those from ROIsl. Multivariate analysis showed that the Ktrans of ROIwt was a predictor of the immediate ablation response. ROC analysis displayed that the AUC of Ktrans of ROIwt is 0.817 in predicting the ablation response.Conclusion: Pretreatment Ktrans of ROIwt is more reliable and stable than that of ROIsl. It could be a predictor for the immediate ablation response of uterine fibroids in MR-HIFU. [ABSTRACT FROM AUTHOR]

Objectives: To determine sonographic association of uterine fibroids with infertility among women of childbearing age. Study Design: Cross-sectional study. Setting: Gilani Ultrasound Clinic opposite Lahore General Hospital, University of Lahore. Ahsan Diagnostic Centre, Sialkot. Period: From 10th July to 10th October 2018. Materials & Methods: The study was started after the approval of ethical committee of the University of Lahore. All the patients were enrolled in this study after signing the informed consent form. Toshiba Xario and Medison Accuvix V20 with convex transducer frequency ranging from 2 to 6 MHz were used. Fibroids were evaluated through trans-abdominal scan and sonographic data was stored in the ultrasound machine. A convenient sampling technique was used and data was further analyzed with the help of Statistical Package for the Social Sciences version 24 (SPSS 24, IBM, Armonk, NY, United States of America). Results: Among 113 subjects, the incidence of uterine fibroid was 32.7%. A significant association (p-value=0.010) was seen between existence of fibroid and the type of Infertility. The mean size of the fibroids was found to be 32.3568mm, 26(23.0%) of participants had single while 11(9.7%) of them had multiple fibroids. The location was most commonly seen in anterior and posterior wall, whereas the most common type was found to Sub-Mucosal and Sub-Serosal. Conclusion: Uterine Fibroids were commonly associated with Secondary infertility as compared to primary infertility. [ABSTRACT FROM AUTHOR]

Uterine fibroids are the most common benign tumor that can be found in a woman's reproductive system. The uterine fibroid affects millions of women globally each year and we can consider this pathology, without exaggerating, an important public health problem. Our study was carried out prospectively, in 5 years (2015-2019) and enrolled 480 patients selected with uterine fibroid, from a number of 28809 women who were hospitalized during this period in the university clinic of Obstetrics and Gynecology within the „Saint Pantelimon" Emergency Hospital, Bucharest, Romania. Patients were divided into two groups of study: Group A, those with well-defined, single or multiple uterine fibroid and Group B - patients with diffuse uterine fibromatosis. The clinical, histopathological and immunohistochemical study analyzed and monitored over time, by comparison between the two groups, 52 parameters for each patient, starting with the usual epidemiological factors (age, weight, height, body mass index, personal or family medical history, etc.), continuing with those related to fertility and other clinical issues (chronic pain, metrorrhagia, number of births, recurrent miscarriage, etc.), up to intraoperative parameters (duration of surgery, blood loss, pelvic drainage, the need for blood transfusion) and finally, histopathological aspects. We present in this article some of the results of our study, those related to the quality of the endometrium in the fibromatous uterus and the influence that uterine fibroid had on the fertility of our patients. [ABSTRACT FROM AUTHOR]

A 32-year-old multiparous rural woman having 26 weeks of pregnancy with giant uterine fibroid extending up to the cervix had stillbirth 2 weeks back and left hospital against medical advice. She was readmitted in emergency with necrotic prolapsed uterine fibroid with offensive vaginal bleeding. On examination, the patient had necrotic prolapsed fibroid with very offensive bloody discharge and a large number of larvae of Dermatobia hominis (human botfly) were crawling in necrotic tissue. The location of this infestation at genital region is an extremely rare occurrence in postdelivery patients. [ABSTRACT FROM AUTHOR]

Background: Twin pregnancies with uterine fibroid(s) (UFs) may not be at increased risk for obstetric complications compared to those without UFs. However, there was no reported comparison study with obstetric outcomes and complications of twin pregnancy after myomectomy. We aimed to compare the pregnancy outcomes in twin pregnancies with or without uterine fibroid(s), and also compared in patients with previous myomectomy history in Korean women.Methods: A cohort of twin pregnancies delivered in a single institution between January 2011 and March 2019 were retrospectively analyzed. UFs group was defined by the presence of UFs during pregnancy (≥1 fibroid, measuring ≥2 cm or multiple fibroids regardless of the size). Previous myomectomy group included patients with history of abdominal or laparoscopic or hysteroscopic myomectomy of ≥1 fibroid, measuring ≥2 cm or multiple fibroids whatever the size. Patients with monochorionic monoamniotic twins, myoma less than 2 cm in size, missed abortion or intrauterine fetal death (IUFD) of one fetus before 14 weeks, history of previous conization, and uterine anomalies were excluded. Pregnancy outcomes and obstetric complications were compared.Result: A total 1388 patients were included in this study, 191 (13.8%) had UFs and 89 (6.4%) had a history of myomectomy. Maternal age was younger in non-UFs group and primiparity was more common in UFs group (p < 0.001, and p = 0.019). No significant differences were found in the gestational age at delivery (p = 0.657), delivery before 37 weeks (p = 0.662), delivery before 34 weeks (p = 0.340), and sum of birth weight of twin (p = 0.307). There were also no statistical differences in rates of obstetrical complications, such as preeclampsia, gestational diabetes mellitus, placenta previa, placenta abruption, cerclage, small for gestational age, IUFD, postpartum hemorrhage and peripartum transfusion or ICU care. These obstetrical outcomes and complications showed no statistical differences between UFs group and previous myomectomy group.Conclusion: In patients with twin pregnancies, the presence of UFs or history of previous myomectomy did not relate to negative effects on pregnancy outcomes and obstetrical complications. [ABSTRACT FROM AUTHOR]

What is the effect of quercetin and indole-3-carbinol (I3C) on extracellular matrix expression, cell migration and proliferation in human myometrial and uterine leiomyoma cells. Myometrial and leiomyoma cells were treated with quercetin or I3C at different concentrations (10 µg/ml; 50 µg/ml; 100 µg/ml; and 250 µg/ml) for 48 h to measure mRNA and protein expressions of extracellular matrix (collagen 1A1, fibronectin and versican), as well as cell migration and the proliferation rate. Quercetin decreased mRNA levels of collagen 1A1 in myometrial (P < 0.0001) and leiomyoma cells (P < 0.0001). Quercetin reduced mRNA and protein levels of fibronectin in myometrial cells (P < 0.05) and fibronectin protein in leiomyoma cells (P < 0.05). I3C reduced collagen 1A1 mRNA levels in myometrial (P < 0.05) and leiomyoma cells at higher dose (P < 0.05). The protein levels of fibronectin were also reduced in both myometrial and leiomyoma cells with highest dose of I3C (P < 0.05), although mRNA levels were not affected in leiomyoma cells. Neither quercetin nor I3C treatment altered versican mRNA levels in both cell types. A significant reduction of the migration of both myometrial and leiomyoma cells in response to quercetin was observed (P < 0.05) and I3C (P < 0.05 for myometrial and P < 0.01 for leiomyoma cells) treatment. Both quercetin and I3C significantly reduced myometrial cell proliferation (P < 0.05). The in-vitro anti-fibrotic, anti-migratory and anti-proliferative effects of quercetin and I3C form the scientific basis for developing new therapeutic, preventive agents, or both, for uterine leiomyomas. [ABSTRACT FROM AUTHOR]

Uterine fibroids (UFs) or leiomyoma are frequently associated with somatic mutations in the mediator complex subunit 12 (MED12) gene; however, the function of these mutations in human UF biology is yet to be determined. Herein, we determined the functional role of the most common MED12 somatic mutation in the modulation of oncogenic Wnt4/β-catenin and mammalian target of rapamycin (mTOR) signaling pathways. Using an immortalized human uterine myometrial smooth muscle cell line (UtSM), we constitutively overexpressed either MED12-Wild Type or the most common MED12 somatic mutation (c.131G>A), and the effects of this MED12 mutation were compared between these cell lines. This immortalized cell line was used as a model because it expresses wild type MED12 protein and do not possess MED12 somatic mutations. By comparing the effect between MED12-WT and MED12-mutant (mut) stable cell populations, we observed increased levels of protein expression of Wnt4 and β-catenin in MED12-mut cells as compared with MED12-WT cells. MED12-mut cells also expressed increased levels of mTOR protein and oncogenic cyclin D1 which are hallmarks of cell growth and tumorigenicity. This somatic mutation in MED12 showed an effect on cell-cycle progression by induction of S-phase cells. MED12-mut cells also showed inhibition of autophagy as compared with MED12-WT cells. Together, these findings indicate that the MED12 somatic mutation has the potentials for myometrial cell transformation by dysregulating oncogenic Wnt4/β-catenin and its downstream mTOR signaling which might be associated with autophagy abrogation, cell proliferation, and tumorigenicity. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the efficacy and safety of a new portable ultrasound-guided high-intensity focused ultrasound system (USgHIFU) with advanced targeting and beam steering technology for the treatment of uterine fibroids.Methods: Fifty-nine uterine fibroids from 36 participants (mean age, 44.9 ± 4.1 years) were included from November 2013 to November 2015. All participants were treated with HIFU, with 3D electronic steering. MR imaging studies were performed before HIFU, immediately after HIFU, and 1 month and 3 (or 5) months after the HIFU treatment. The non-perfused volume ratio (NPVR), fibroid volume shrinkage (FVS), symptom improvement, quantified life quality assessment, and safety were analyzed. A long-term follow-up was conducted in July to December 2017 (mean, 32.2 months).Results: The volume of the treated uterine fibroids ranged from 7.5 to 274.4 cm3 (mean, 69.8 cm3; SD, 64.3 cm3). The mean NPVR on the immediate post-HIFU MR imaging was 74.8 ± 25.2%. The mean FVS was 17.3% at 1 month, 33.3% at 3 months, and 45.1% at 5 months after HIFU treatment. The mean treatment time was 44.6 ± 28.2 min per fibroid and 72.9 ± 31.4 min per participant. Uterine fibroid-related symptoms and quality of life showed statistically significant improvement after the HIFU treatment. No significant symptoms related to safety or complications occurred. In the long-term follow-up, 78.8% of those surveyed were satisfied with their HIFU treatment.Conclusion: This clinical trial showed that a portable USgHIFU with advanced functions may safely and effectively treat uterine fibroids.Key Points: • A portable compact ultrasound-guided high-intensity focused ultrasound (HIFU) can effectively and safely treat uterine fibroids. • Advanced functions, such as portability, targeted forecasting, electronic beam steering, and interleaved scanning, might be helpful in enhancing the clinical applicability of ultrasound-guided high-intensity focused ultrasound. • In the long-term follow-up of more than 2 years, approximately 80% of those surveyed were satisfied with their HIFU treatment. [ABSTRACT FROM AUTHOR]

The incidence of uterine fibroids, which comprise one of the most common female pelvic tumors, is almost 70-75% for women of reproductive age. With the development of surgical techniques and skills, more individuals prefer minimally invasive methods to treat uterine fibroids. There is no doubt that minimally invasive surgery has broad use for uterine fibroids. Since laparoscopic myomectomy was first performed in 1979, more methods have been used for uterine fibroids, such as laparoscopic hysterectomy, laparoscopic radiofrequency volumetric thermal ablation, and uterine artery embolization, and each has many variations. In this review, we compared these methods of minimally invasive surgery for uterine fibroids, analyzed their benefits and drawbacks, and discussed their future development. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the effect of symptoms of uterine fibroid on the quality of life of patients. A prospective study included 30 patients with symptomatic uterine fibroid aged 27 to 49 years. Participants passed the UFS-QOL questionnaire. The Quality of Life Index was 63,6 ± 18,4 points, which indicated a decrease in the quality of life under the influence of symptoms of uterine fibroid. The decrease in the quality of life of patients with uterine fibroid was caused by negative symptoms, which affect the parameters associated with physical activity, pain, and psychological health. Thus, the assessment of the Quality of Life Index has independent prognostic value and can be used when choosing a treatment strategy for patients with uterine fibroid. [ABSTRACT FROM AUTHOR]

To compare the pregnancy outcomes between ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation and laparoscopic myomectomy (LM). This study included 676 women with symptomatic uterine fibroids who wished to become pregnant underwent USgHIFU or LM at three hospitals in China from 1 May 2009 to 31 May 2018. The related information of pregnancy and delivery were followed up and analyzed using the chi-square test and two-sided Student t-test. The median follow-up duration was 5 (1–8) years; 20 patients (2.9%) were lost to follow-up. 320 patients were treated with UsgHIFU, and 336 were treated with LM. Two hundred nineteen (68.4%) women became pregnant after USgHIFU ablation, and 224 (66.7%) became pregnant after LM. Four hundred forty-three patients had 501 pregnancies (natural pregnancies, 405; in vitro fertilisation-embryo transfer pregnancies, 38). Average times to pregnancy were 13.6 ± 9.5 months after USgHIFU and 18.9 ± 7.3 months after LM (p < 0.05). The rate of cesarean delivery was lower in the USgHIFU group (41.6%) than in the LM group (54.9%) (p < 0.05). Incidences of placenta increta, placenta previa, and postpartum hemorrhage were low after USgHIFU compared with after LM. Incidences of preterm birth, fetal distress, fetal growth restriction, and puerperal infection were higher after USgHIFU than after LM. There was a risk of uterine rupture after both procedures. Compared with LM, USgHIFU ablation can significantly shorten the time to pregnancy, although pregnancy rates of the two procedures are similar. Some risks in pregnancy and delivery after HIFU should be evaluated and monitored. [ABSTRACT FROM AUTHOR]

To evaluate endopelvic fascial swelling in patients with uterine fibroids after high-intensity focused ultrasound (HIFU) ablation on magnetic resonance imaging (MRI) and investigate the factors that influence endopelvic fascial swelling. MRI and clinical data from 188 patients with uterine fibroids who were treated with HIFU were analyzed retrospectively. The patients were divided into a fascial swelling group and a non-swelling group, and the degree of swelling was graded. Fascial swelling was set as the dependent variable, and factors such as baseline characteristics and HIFU parameters, were set as the independent variables. The relationship between these variables and fascial swelling was analyzed by univariate and multivariate analyses. Correlations between the factors and the degree of fascial swelling were evaluated by Kruskal–Wallis test. The univariate analysis revealed that the fibroid location, distance from the fibroid to the sacrum, sonication time, treatment time, treatment intensity, therapeutic dose (TD), and energy efficiency (EEF) all affected the endopelvic fascial swelling (p < 0.05). Subsequently, multivariate analysis showed that the distance from the fibroid to the sacrum was significantly correlated with fascial swelling (p < 0.05). Moreover, TD and sonication time were significantly positively correlated with the degree of fascial swelling (p < 0.05). The incidence of sacrococcygeal pain was significantly correlated with fascial swelling (p < 0.05). The distance from the fibroid to the sacrum was a protective factor for fascial swelling. TD and sonication time were significantly positively correlated with the degree of fascial swelling. [ABSTRACT FROM AUTHOR]

On 14 December 2016, independent and hospital-based gynaecologists gathered in Frankfurt am Main for an expert meeting with a view to developing a consensus paper on the treatment of uterine fibroids (leiomyomas) in gynaecological practice. Attention was paid in particular to the new aspects of targeted pharmacotherapy. The experts reached consensus on the requisite diagnostic examinations, and devised an algorithm for managing symptomatic uterine fibroids in premenopausal and perimenopausal women. The central decision in the treatment algorithm is the question whether there is a desire to preserve the uterus. Prior to performing hysterectomy in an anaemic patient not wanting to preserve the uterus, preoperative treatment with UPA is worthwhile. If there is an indication for surgery combined with the desire to preserve the uterus, it is necessary to consider from the surgeon’s perspective, how useful it would be to undertake preoperative treatment with UPA. In particular, this applies to hysteroscopic resection. Preoperative treatment may also be worthwhile prior to laparoscopy and laparotomy procedures if there are large or multiple fibroids as per FIGO 2. In case of secondary anaemia or fibroids in an unfavourable location, especially in patients who wish to have children, e.g. close to the tubes or cervix, preoperative pharmacological treatment with UPA may also be indicated. The surgery can thus be optimised and in patients wishing to have children it will prove less detrimental. In general, in the management of fibroids, it is preferable to take a causal approach early on by employing targeted pharmacological treatments. Combined oral contraceptives, progestins and LNG-IUS therefore are not advantageous in such a situation. Flexible interval therapy with UPA, ideally beginning with two 12-week courses of treatment separated by a treatment-free interval of approximately two months, offers an alternative to surgical and interventional radiological procedures. As experts says, the use of targeted, long-term pharmacological treatments can help reduce the need for surgery on uterine fibroids and also lower the number of hysterectomies, in particular, and in the long term improve patient quality of life.

To observe and analyze the effect of color doppler ultrasonography (CDU) in uterine arterial embolization (UAE).

The objective of this study was to assess the tolerability and efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation using a Haifu JC Focused Ultrasound Tumor Therapeutic System (operating transducer frequency: 0.8 MHz, 300-400 W/cm2) under real-time ultrasound guidance (2.5- to 5.0-MHz imaging probe) for uterine fibroids and adenomyosis in 1807 patients (928 with fibroids and 889 with adenomyosis). Volume change and clinical symptom improvement after treatment were evaluated based on symptom severity scores and health-related quality of life scores using the Uterine Fibroid Symptom and Quality of Life questionnaires. At 3, 6 and 12 mo after treatment, symptom severity scores and health-related quality of life scores and reductions in volumes of uterine adenomyosis and fibroids all revealed good effects. The complication rate was 4.6% (84/1807). With supportive care, all complications resolved without any permanent adverse effects. Thus, USgHIFU is an effective, non-invasive modality for treating uterine fibroids and adenomyosis with manageable complications. [ABSTRACT FROM AUTHOR]

The use of a modified energy transmission protocol and oxytocin augmentation is being proposed as a high-intensity-focused ultrasound (HIFU) treatment for uterine fibroids, to aim for an effective and well-tolerable treatment to be given as an out-patient procedure without anesthesia or sedation. The objective of this study was to evaluate the safety and treatment effectiveness of this new protocol. The treatment outcomes of 9 consecutive patients (study group) were compared with those of 51 patients (control group) who had been randomized (1:1) to receive HIFU (n = 24) or uterine artery embolization ([UAE] n = 27). There was no major adverse event. At 3 mo, the median proportion of fibroid volume compared with the baseline was 51.1% in the study group, significantly smaller than that in the control groups (HIFU 76.6%, UAE 66.2%). At 6 mo, all patients in the study group became symptom free (9/9, 100%), a result significantly better than that of both control groups. The proportion of patients with good quality of life was significantly higher in the study group (5/7, 71.4%) compared with the control groups (HIFU 3/24, 12.5%; UAE 7/27, 25.9%). Within 24 mo, none of the patients in the study HIFU group required re-intervention, a result significantly better than that in the control HIFU group (15/24, 62.5%). The treatment could result in a very promising long-term imaging and clinical outcome that may be better than those of UAE; however, a randomized control trial of larger scale is required for further evaluation of this treatment. [ABSTRACT FROM AUTHOR]

Background: Uterine fibroids (UFs) are the most common benign tumors of the uterus with an unknown etiology, affecting many women of reproductive age. We aimed to evaluate the association between UFs and anthropometric features, subcutaneous and preperitoneal fat thickness and lipid profile. Methods: This is a case-control study conducted on 212 women who were available in the Al-Zahra specialized referral hospital from March 2018 to March 2019. Study variables including weight, height, waist and hip circumference were measured for all individuals. For patients with UFs, the size, number and location of fibroids were recorded. Also, subcutaneous and preperitoneal fat thicknesses were measured. Finally, the data were analyzed using the SPSS software ver.16.0 Results: The most common complaint was abnormal uterine bleeding (AUB) in both groups. Most of the patients had a body mass index (BMI) of 25-30. There were significant differences between the two groups in terms of age (P = 0.0001) and waist circumference (P = 0.011). Cholesterol levels were much higher in the case group. Only age and low-density lipoprotein-cholesterol (LDL-C) levels in the case group were positively related to developing UFs, such that with advancing aging and increasing levels of LDL-C, the likelihood of experiencing UFs rose by 10% and 1.1%, respectively. Also, there were no significant differences between the two groups regarding in either preperitoneal fat thickness (PFT) or subcutaneous fat thickness (SFT). Conclusion: Our findings suggest that with aging and higher levels of LDL-C, the likelihood of developing UFs rises. [ABSTRACT FROM AUTHOR]